Kayleeanna Williams

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

2900 W Broadway Ave Ste B
Moses Lake, WA 98837-4518

Phone

(602) 377-2012

NPI assigned

Dec 12, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1417725136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 E CAROL ANN WAY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323820",
            "telephone_number": "509-431-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W BROADWAY AVE STE B",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988374518",
            "telephone_number": "602-377-2012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4175 N Goldwater Blvd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852513850",
            "country_code": "US",
            "telephone_number": "602-377-2012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KAYLEEANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Chase Whittaker
• Kellie Elizabeth Wilcox, ARNP
• Aaron R Wilder
• Barbara Wilkinson
• Christie Williams, BA
• Ryan D Williams, PA-C
• Tanyr Lyn Williams
• Debra A Willis, DMD
• Ciara Wilson, LMP
• Luz Menendez Wilson, RN

• Specialist in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.