NPIMap

Individual provider Active NPI

Kyle David Williams

  • Physician Assistant
  • Fort Collins, CO
National Provider Identifier
1346823960
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0008557 Issued in CO
Practice address
3491 E Harmony Rd Ste 230
Fort Collins, CO 80528-8824
Phone
(970) 449-0285
Fax
(720) 925-5897
NPI assigned
May 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 390200000X
Physician Assistant 363A00000X PA.0008557 CO Primary

Addresses

Primary practice location

3491 E Harmony Rd Ste 230
Fort Collins, CO 80528-8824

Mailing address

5445 DTC Pkwy Ste 1130
Greenwood Village, CO 80111-3038
Phone (720) 749-5599

Other practice location 1

1573 Sorenson Dr
Windsor, CO 80550-4606
Phone (970) 389-9668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240716003358 CO Practitioner - Physician Assistant 9335684166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mountain View Pain SpecialistsGroup PAC ID 7911255013, 53 clinicians

Practice addresses (Care Compare)

15901 E Briarwood Cir
Unit 150
Aurora, CO 80016-1787
Phone (303) 645-4363

3491 E Harmony Rd
Suite 230
Fort Collins, CO 80528-8824
Phone (720) 749-5599

Hospital & facility affiliations

  • Banner North Colorado Medical Center Hospital, Greeley, CO, CCN 060001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Pain Specialists CurrentSince Jul 1, 2024 Accepting new patients

Locations

15901 E Briarwood Cir
Unit 150
Aurora, CO 80016
Phone (303) 645-4363

3491 E Harmony Rd
Ste 230
Fort Collins, CO 80528
Phone (970) 449-0285

5445 Dtc Pkwy
Ste 1130
Greenwood Village, CO 80111

Interoperability endpoints

  • Direct secure messaging: kyle.williams@3675.securemail.prognocis.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1346823960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 DTC PKWY STE 1130",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113038",
            "telephone_number": "720-749-5599",
            "fax_number": "720-925-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3491 E HARMONY RD STE 230",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288824",
            "telephone_number": "970-449-0285",
            "fax_number": "720-925-5897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1573 Sorenson Dr",
            "address_purpose": "LOCATION",
            "city": "Windsor",
            "state": "CO",
            "postal_code": "805504606",
            "country_code": "US",
            "telephone_number": "970-389-9668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KYLE",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-02",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": "390200000X",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.