Active NPI
Mark K Williams, DPM
- Foot & Ankle Surgery Podiatrist
- Olympia, WA
National Provider Identifier
1528087293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- PO00000429
- Practice address
- 165 Lilly Rd NE Ste a
Olympia, WA 98506-5028 - Phone
- (360) 438-9092
- Fax
- (360) 438-3906
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PO00000429 | WA | Primary |
Addresses
Primary practice location
165 Lilly Rd NE Ste a
Olympia, WA 98506-5028
Mailing address
165 Lilly Rd NE Ste a
Olympia, WA 98506-5028
Phone (360) 438-9092
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 480025913 | Other | MEDICARE RR | |
| 1302363 | Medicaid | WA | |
| 54484 | Other | WA | L&I |
| WI6319 | Other | WA | REGENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kelley a. Gillroy-Gill | Foot & Ankle Surgery | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Olympia, WA
- NPI 1750775037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273881600000",
"number": "1528087293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 LILLY RD NE STE A",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065028",
"telephone_number": "360-438-9092",
"fax_number": "360-438-3906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 LILLY RD NE STE A",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065028",
"telephone_number": "360-438-9092",
"fax_number": "360-438-3906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MARK",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2010-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "WA",
"license": "PO00000429",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "480025913",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1302363",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I",
"identifier": "54484",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "WI6319",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.