Active NPI
Michael Shawn Williams, PSYCHOLOGIST
- Psychologist
- Fort Meade, SD
National Provider Identifier
1205843141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 448
- Practice address
- 113 Comanche Rd
Fort Meade, SD 57741-1002 - Phone
- (605) 347-2511
- NPI assigned
- Aug 2, 2006
- Last updated
- Oct 9, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 448 | SD | |
| Psychologist | 103T00000X | 448 | SD | Primary |
Addresses
Primary practice location
113 Comanche Rd
Fort Meade, SD 57741-1002
Mailing address
113 Comanche Rd
Fort Meade, SD 57741-1002
Phone (605) 347-2511
Other practice location 1
2640 Jackson Blvd Ste 1
Rapid City, SD 57702-3400
Phone (605) 441-1001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 448 | SD | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosebud Indian Health Service | Past | Accepting new patients | |
| Red Horse Healing | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Rapid City, SD
- NPI 1992240329
-
- Ambulatory Surgical Clinic/Center
- Rosebud, SD
- NPI 1790955128
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759968000000",
"number": "1205843141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 COMANCHE RD",
"city": "FORT MEADE",
"state": "SD",
"postal_code": "577411002",
"telephone_number": "605-347-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 COMANCHE RD",
"city": "FORT MEADE",
"state": "SD",
"postal_code": "577411002",
"telephone_number": "605-347-2511"
}
],
"practiceLocations": [
{
"address_1": "2640 Jackson Blvd Ste 1",
"address_purpose": "LOCATION",
"city": "Rapid City",
"state": "SD",
"postal_code": "577023400",
"country_code": "US",
"telephone_number": "605-441-1001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MICHAEL",
"middle_name": "SHAWN",
"name_prefix": "Mr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2025-10-09",
"certification_date": "2025-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "SD",
"license": "448",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "SD",
"license": "448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Meade, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.