Williams Eyecare Group LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

01119 Issued in AZ

Legal business name

WILLIAMS EYECARE GROUP LLC

Practice address

3250 Gateway Blvd Ste 152
Prescott, AZ 86303-6857

Phone

(928) 442-9202

Fax

(928) 442-3980

NPI assigned

Feb 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kenneth W Williams, O.D.NPI 1710007711

Title

Owner, OD

Phone

(928) 442-9202

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Walter Williams, OD

  • Optometrist
  • Prescott, AZ
  • NPI 1710007711
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1245378496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 GATEWAY BLVD STE 152",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863036857",
            "telephone_number": "928-442-9202",
            "fax_number": "928-442-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 GATEWAY BLVD STE 152",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863036857",
            "telephone_number": "928-442-9202",
            "fax_number": "928-442-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMS EYECARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER, OD",
        "authorized_official_telephone_number": "928-442-9202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "01119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Franklin Willard, PA-C
• Sheila Michelle Willems, O.D.
• Willer Optometry, Inc
• Patrick Allen Willer, OD
• William E. Perry, MD, PC
• Ashleigh Williams
• Bradley David Williams, MD, PHD
• Karlyn Williams, MD
• Kathleen S Williams, R.D.
• Kenneth Walter Williams, OD

• Optometrist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.