Individual provider Active NPI

Bryan Joseph Williams, D.P.M.

  • Podiatrist
  • Matthews, NC
National Provider Identifier
1508215179
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
724 Issued in NC
Practice address
428 N Trade St Ste 100
Matthews, NC 28105-1729
Phone
(704) 841-4000
Fax
(704) 841-4338
NPI assigned
Jun 6, 2016
Last updated
May 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 724 NC Primary

Addresses

Primary practice location

428 N Trade St Ste 100
Matthews, NC 28105-1729

Mailing address

428 N Trade St Ste 100
Matthews, NC 28105-1729
Phone (704) 841-4000

Other practice location 1

2607 E 7th St Ste 100
Charlotte, NC 28204-4308
Phone (704) 841-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, UT, NE, ID4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20190806002711 NC Practitioner - Podiatry 1456688936 Reassigns benefits to 1 organization
I20241123000399 UT Practitioner - Podiatry 1456688936 Reassigns benefits to 2 organizations
I20250430003437 NE Practitioner - Podiatry 1456688936 Reassigns benefits to 1 organization
I20250618001576 ID Practitioner - Podiatry 1456688936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ryan K Anderson D P M P CGroup PAC ID 7517999121, 51 clinicians
Mountain West Podiatry LLCGroup PAC ID 7618348616, 6 clinicians
Proactive Wound Care NE IncGroup PAC ID 1759807977, 5 clinicians

Practice addresses (Care Compare)

380 S Main St
Centerville, UT 84014-2266
Phone (801) 447-1615

650 J St
Suite 405
Lincoln, NE 68508-2924
Phone (801) 815-6862

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue102
Removal of nail tissue1474
Removal or shaving of skin growth381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
724NCMDMental Health Counselor
405NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Wound Care Inc Podiatrist CurrentSince Jan 13, 2025 Accepting new patients
Proactive Wound Care Id Inc. Podiatrist CurrentSince Apr 14, 2025 Accepting new patients
Proactive Wound Care NE Inc Podiatrist CurrentSince Mar 18, 2025 Accepting new patients
Mountain West Podiatry LLC Podiatrist CurrentSince Sep 12, 2024 Accepting new patients
Ryan K Anderson D P M P C Podiatrist CurrentSince Jun 13, 2025 Accepting new patients
Eastover Foot & Ankle PA Podiatrist CurrentSince Jul 8, 2019 Accepting new patients
Utah Podiatric Physicians and Surgeons Group LLC Podiatrist Past Accepting new patients

Locations

2607 E 7th St
Ste 100
Charlotte, NC 28204
Phone (704) 708-3403

650 J St
Ste 405
Lincoln, NE 68508
Phone (801) 815-6500

596 W 750 S
Ste 200
Bountiful, UT 84010
Phone (801) 292-4425

1231 N 1300 W
Ste A
Centerville, UT 84014
Phone (801) 815-6500

380 S Main St
Centerville, UT 84014
Phone (530) 869-1444

11762 S State St
Ste 340
Draper, UT 84020
Phone (801) 562-9294

434 W Ascension Way
Ste 425
Salt Lake City, UT 84123

596 W 750 S
Ste 300
Woods Cross, UT 84010
Phone (801) 673-7661

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1508215179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 N TRADE ST STE 100",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281051729",
            "telephone_number": "704-841-4000",
            "fax_number": "704-841-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 N TRADE ST STE 100",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281051729",
            "telephone_number": "704-841-4000",
            "fax_number": "704-841-4338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2607 E 7th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282044308",
            "country_code": "US",
            "telephone_number": "704-841-4000",
            "fax_number": "704-376-7054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRYAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.