Malissa R Williams

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

17-03963 Issued in KS

Practice address

12802 Johnson Dr
Shawnee, KS 66216-1645

Phone

(913) 228-1407

NPI assigned

Oct 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smart Rehab, LLCGroup PAC ID 1759668643, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Smart Rehab, LLC

  • Physical Therapist
  • Kirkwood, MO
  • NPI 1144760471
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1619692084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 NW 38TH ST APT 202",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641164555",
            "telephone_number": "636-485-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12802 JOHNSON DR",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662161645",
            "telephone_number": "913-228-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MALISSA",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-03963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhiannon Wilhite, OTD
• Amber Marie Williams, FNP-BC
• Angela M Williams, DDS, MS
• Briana Williams
• Karen Williams
• Nathan Williams, LPC
• Robyn Diane Williams, DPT
• Amy R Williamsen, PHARM.D.
• Blake Jerald Williamson, MD
• Randa Williamson

• Occupational Therapist in Shawnee, KS
• Providers in Shawnee, KS by specialty
• Occupational Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.