Mary Katherine Williams, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-02907 Issued in NC

Practice address

8020 Creedmoor Rd
Raleigh, NC 27613-4363

Phone

(919) 322-2844

Fax

(919) 322-2898

NPI assigned

Jun 20, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

American Family Care Fuquay PLLCGroup PAC ID 6103258306, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rex Hospital Hospital, Raleigh, NC, CCN 340114

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• American Family Care Fuquay PLLC

  • Urgent Care Clinic/Center
  • Fuquay Varina, NC
  • NPI 1770135808
  Medicare reassignment Care Compare group
• Capital Partnership, LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Cary, NC
  • NPI 1467654210
  Medicare reassignment NPD
• Alignment Healthcare Medical Associates PC

  • Clinic/Center
  • Garner, NC
  • NPI 1588052849
  NPD
• Raleigh Durham Medical Group PA

  • Family Medicine Physician
  • Cary, NC
  • NPI 1295784874
  NPD (past)
• Rex Hospital Inc

  • Cardiovascular Disease Physician
  • Raleigh, NC
  • NPI 1972939643
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rex Hospital Inc.

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1497797088
  Care Compare affiliation

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1588959407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8020 CREEDMOOR RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276134363",
            "telephone_number": "919-322-2844",
            "fax_number": "919-322-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8020 CREEDMOOR RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276134363",
            "telephone_number": "919-322-2844",
            "fax_number": "919-322-2898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11200 Governor Manly Way Ste 114",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276147360",
            "country_code": "US",
            "telephone_number": "919-570-7660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588959407",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1759N",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwilliams211614@direct.unc.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "11200 Governor Manly Way Ste 114",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276147360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madelyn Williams
• Maggy Williams
• Mandale M Williams Sr.
• Mantryll Williams
• Margot Maryanne Williams, PH.D.
• Mechal Noell Williams
• Melinda L Williams, PNP
• Michael Gabriel Williams
• Misty Williams
• Najair Williams

• Physician Assistant in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.