Makenzie Williams, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

414 S University Rd
Spokane Valley, WA 99206-5555

Phone

(509) 868-0876

NPI assigned

Jan 14, 2016

Last updated

Sep 13, 2018By the provider in NPPES

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

Other names 1

• Ms. Makenzie Bullock Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Avalon Care Center - Spokane LLC

  dba Avalon Care Center - Northpointe

  • Skilled Nursing Facility
  • Spokane, WA
  • NPI 1992799266
  NPD (past)

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1437515855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 N ARC",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "99216",
            "telephone_number": "208-240-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 S UNIVERSITY RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992065555",
            "telephone_number": "509-868-0876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17121 E 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "990168556",
            "country_code": "US",
            "telephone_number": "509-868-0876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MAKENZIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAKENZIE",
            "last_name": "BULLOCK",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Donald K Williams, DO
• Elaine Williams, LMHC
• Grace Heise Williams, DMD
• Jeremy Michael Williams, DMD
• Judith Anne Williams, LPN
• Scott A Williams, WA STATE LIC HA2083
• William M Williams III, M.D.
• Brenda Willoughby
• Wilson Therapy LLC
• David V. Wilson II, LICSW

• Physician Assistant in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.