Individual provider Active NPI

Daniel Bryan Williams

  • Acute Care Nurse Practitioner
  • Kettering, OH
National Provider Identifier
1629695358
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.0041542 Issued in OH
Practice address
3533 Southern Blvd Ste 2100
Kettering, OH 45429-1267
Phone
(937) 395-8556
Fax
(937) 395-6375
NPI assigned
Jun 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95016523 CA
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.0041542 OH Primary

Addresses

Primary practice location

3533 Southern Blvd Ste 2100
Kettering, OH 45429-1267

Mailing address

4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Phone (937) 257-8718

Other practice location 1

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 395-6665

Other practice location 2

4881 Sugar Maple Dr
Wpafb, OH 45433-5529
Phone (937) 257-8718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20260423001873 OH Practitioner - Nurse Practitioner 7416363544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Prestige PL
Suite 550
Miamisburg, OH 45342-3789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95016523CAMDAcute Care Nurse Practitioner
APRN.CNP.0041542OHMDAcute Care Nurse Practitioner

Organizations & group practices 1

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": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1629695358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WPAFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-257-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD STE 2100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291267",
            "telephone_number": "937-395-8556",
            "fax_number": "937-395-6375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-395-6665",
            "fax_number": "937-395-6376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4881 Sugar Maple Dr",
            "address_purpose": "LOCATION",
            "city": "Wpafb",
            "state": "OH",
            "postal_code": "454335529",
            "country_code": "US",
            "telephone_number": "937-257-8718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DANIEL",
        "middle_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-29",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95016523",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.0041542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.