Mary Kay Williams, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704123296 Issued in MI

Practice address

1221 Sixth St Ste 306
Traverse City, MI 49684-2361

Phone

(231) 935-2400

Fax

(231) 392-2424

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Munson Medical Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860
  Medicare reassignment NPD
• Munson Medical Center

  • Internal Medicine Physician
  • Traverse City, MI
  • NPI 1508390741

  Nurse Practitioner

  NPD
• Munson Medical Center

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1881623031
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1366461121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W FRONT ST",
            "address_2": "STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842236",
            "telephone_number": "231-346-4023",
            "fax_number": "231-932-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 SIXTH ST STE 306",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842361",
            "telephone_number": "231-935-2400",
            "fax_number": "231-392-2424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 W Front St",
            "address_2": "STE 200",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842236",
            "country_code": "US",
            "telephone_number": "231-346-4023",
            "fax_number": "231-932-7311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARY",
        "middle_name": "KAY",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704123296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mary.williams@gts.eclinicadirect.com",
            "affiliation": "N",
            "address_1": "1221 Sixth St Ste 306",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cathye Williams, BA
• Chandler Gibson Williams, NP
• Charles Hubbard Williams III
• Charles Paul Williams, MD
• Drew Reyner Williams
• Mary Lou Williams, M.A.
• Natasha A Williams, FNP
• Ian Daniel Williamson
• Jason Lee Williamson, PHARM.D.
• Shania Willingham

• Nurse Practitioner in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.