Active NPI
Kenneth Leamon Williams, D.C.
- Chiropractor
- Gulf Breeze, FL
National Provider Identifier
1649284407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHOOO5184
- Practice address
- 107 Bay Bridge Dr
Gulf Breeze, FL 32561-4470 - Phone
- (850) 932-1778
- Fax
- (850) 934-4770
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHOOO5184 | FL | Primary |
Addresses
Primary practice location
107 Bay Bridge Dr
Gulf Breeze, FL 32561-4470
Mailing address
107 Bay Bridge Dr
Gulf Breeze, FL 32561-7428
Phone (850) 932-1778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120131000387 | FL | Practitioner - Chiropractic | 9436316668 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHOOO5184 | FL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322524800000",
"number": "1649284407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 BAY BRIDGE DR",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325617428",
"telephone_number": "850-932-1778",
"fax_number": "850-934-4770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 BAY BRIDGE DR",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325614470",
"telephone_number": "850-932-1778",
"fax_number": "850-934-4770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KENNETH",
"middle_name": "LEAMON",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2011-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CHOOO5184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.