Individual provider Active NPI

William Dennis, MD

  • Emergency Medicine Physician
  • Glendale, AZ
National Provider Identifier
1629040118
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
61158 Issued in AZ
Practice address
18701 N 67TH Ave
Glendale, AZ 85308-7100
Phone
(623) 561-1000
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 0101231448 VA
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X MD115260 MO
Emergency Medicine Physician 207P00000X 61158 AZ Primary

Addresses

Primary practice location

18701 N 67TH Ave
Glendale, AZ 85308-7100

Mailing address

401 W Pennsylvania Ave
Anaconda, MT 59711-1999
Phone (406) 563-8500

Other practice location 1

6202 Springhill Way
Suffolk, VA 23435-2868
Phone (757) 589-3262

Other identifiers 2

IdentifierTypeStateIssuer
101277407MedicaidPA
1629040118OtherMTNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100621000009 MO Practitioner - Emergency Medicine 1759322639 Reassigns benefits to 1 organization
I20170501002167 MT Practitioner - Emergency Medicine 1759322639 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD115260MOMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
Community Hospital of Anaconda Current Accepting new patients
Emergency Medicine Physicians of Craven County, PLLC Emergency Medicine Past Accepting new patients
Riverside Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Missouri Em-I Medical Services PC Emergency Medicine Past Accepting new patients
Harry S Crawford III MD PLC PastSince Nov 1, 2004 Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients
University Health Physicians Emergency Medicine Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Arizona Post-Acute Medical Services 1 PC Past Accepting new patients

Locations

7245 Raider Rd
Bonne Terre, MO 63628
Phone (573) 358-1400

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

2305 Georgia St
Louisiana, MO 63353
Phone (573) 754-4584

401 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-5261

305 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-8571

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9929/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1629040118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W PENNSYLVANIA AVE",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597111999",
            "telephone_number": "406-563-8500",
            "fax_number": "406-563-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18701 N 67TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087100",
            "telephone_number": "623-561-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6202 Springhill Way",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234352868",
            "country_code": "US",
            "telephone_number": "757-589-3262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "VA",
            "license": "0101231448",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MO",
            "license": "MD115260",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "61158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101277407",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629040118",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.