Individual provider Active NPI

Alyse Williams, M.D.

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1609280486
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9542527-1205 Issued in UT
Practice address
1250 E 3900 S
Suite 260
Salt Lake City, UT 84124-1348
Phone
(801) 265-2000
Fax
(801) 265-2008
NPI assigned
Jun 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9542527-1205 UT Primary

Addresses

Primary practice location

1250 E 3900 S
Suite 260
Salt Lake City, UT 84124-1348

Mailing address

1250 E 3900 S
Suite 260
Salt Lake City, UT 84124-1348
Phone (801) 265-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170822002419 WY Practitioner - Family Practice 5597074765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medical CenterGroup PAC ID 1557344371, 22 clinicians

Practice addresses (Care Compare)

497 W Lott St
Buffalo, WY 82834-1658
Phone (307) 684-2228

Hospital & facility affiliations

  • Susie Bowling Lawrence Hospice Hospice, Buffalo, WY, CCN 531506
  • Johnson County Healthcare Center Hospital, Buffalo, WY, CCN 531308
  • Sheridan Memorial Hospital Hospital, Sheridan, WY, CCN 530006
  • Johnson County Healthcare Center Nursing home, CCN 53Z308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9542527-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Center CurrentSince Sep 1, 2017 Accepting new patients
Johnson County Memorial Hospital Current Accepting new patients
Utah Healthcare Institute Inc Family Medicine PastSince Jul 1, 2000 Accepting new patients

Locations

497 W Lott St
Buffalo, WY 82834
Phone (307) 684-2228

Interoperability endpoints

  • Direct secure messaging: alysewilliams@fmcjc.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1609280486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S",
            "address_2": "SUITE 260",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241348",
            "telephone_number": "801-265-2000",
            "fax_number": "801-265-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S",
            "address_2": "SUITE 260",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241348",
            "telephone_number": "801-265-2000",
            "fax_number": "801-265-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ALYSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9542527-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.