Active NPI
Moab Family Medicine PC
- Family Medicine Physician
- Moab, UT
National Provider Identifier
1528070489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kenneth Lewis Williams, MD
- Title
- Owner/Physician/Partner
- Phone
- (435) 259-7121
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1542 | Other | UT | BUSINESS LICENSE |
| 46D1056014 | Other | UT | CLIA |
National Provider Directory
National Provider DirectoryLocations
476 W Williams Way
#A
Moab, UT 84532
Phone (435) 259-7121
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Medicine Physician
- Moab, UT
- NPI 1376590729
-
- Nurse Practitioner
- Moab, UT
- NPI 1780638973
-
- Physician Assistant
- Londonderry, NH
- NPI 1205142924
-
- Medical Physician Assistant
- Townsend, MT
- NPI 1083797906
-
- Specialist
- Crested Butte, CO
- NPI 1689672735
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": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "UT",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUSINESS LICENSE",
"identifier": "1542",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "46D1056014",
"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.