NPIMap

Organization Active NPI

Moab Family Medicine PC

  • Family Medicine Physician
  • Moab, UT
National Provider Identifier
1528070489
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOAB FAMILY MEDICINE PC
Practice address
476 Williams Way
A
Moab, UT 84532-2065
Phone
(435) 259-7121
Fax
(435) 259-3112
NPI assigned
Aug 12, 2006
Last updated
May 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Authorized official

Name
Dr. Kenneth Lewis Williams, MDNPI 1023091931
Title
Owner/Physician/Partner
Phone
(435) 259-7121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X UT Primary

Addresses

Primary practice location

476 Williams Way
A
Moab, UT 84532-2065

Mailing address

476 Williams Way Ste a
PO Box 1270
Moab, UT 84532-2065
Phone (435) 259-7121

Other identifiers 2

IdentifierTypeStateIssuer
46D1056014OtherUTCLIA
1542OtherUTBUSINESS LICENSE

National Provider Directory

National Provider Directory

Locations

476 W Williams Way
#A
Moab, UT 84532
Phone (435) 259-7121

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1528070489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "476 WILLIAMS WAY STE A",
            "address_2": "PO BOX 1270",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845322065",
            "telephone_number": "435-259-7121",
            "fax_number": "435-259-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 WILLIAMS WAY",
            "address_2": "A",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845322065",
            "telephone_number": "435-259-7121",
            "fax_number": "435-259-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOAB FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN/PARTNER",
        "authorized_official_telephone_number": "435-259-7121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "46D1056014",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "1542",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moab, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.