Active NPI
Kristen G. Williams, PA
- Physician Assistant
- Coral Gables, FL
National Provider Identifier
1548761059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9110791
- Practice address
- 5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423 - Phone
- (305) 661-1515
- Fax
- (305) 662-3723
- NPI assigned
- Feb 21, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9110791 | FL | Primary |
Addresses
Primary practice location
5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Mailing address
5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone (305) 661-1515
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA9110791 | Other | FL | PA LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2018 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9110791 | FL | MD | Physician Assistant |
Interoperability endpoints
- kristen.williams.1@27004.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521417600000",
"number": "1548761059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5955 PONCE DE LEON BLVD",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331462423",
"telephone_number": "305-661-1515",
"fax_number": "305-662-3723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5955 PONCE DE LEON BLVD",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331462423",
"telephone_number": "305-661-1515",
"fax_number": "305-662-3723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KRISTEN",
"middle_name": "G.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-21",
"last_updated": "2018-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9110791",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA LICENSE",
"identifier": "PA9110791",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coral Gables, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.