Active NPI
Kristen Nicole Williams, PA-C
- Medical Physician Assistant
- Winchester, VA
National Provider Identifier
1659835072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0110007062
- Practice address
- 1839 W Plaza Dr
Winchester, VA 22601-6365 - Phone
- (540) 773-2689
- Fax
- (304) 263-6536
- NPI assigned
- Jan 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2355 | WV | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Medical Physician Assistant | 363AM0700X | 0110007062 | VA | Primary |
Addresses
Primary practice location
1839 W Plaza Dr
Winchester, VA 22601-6365
Mailing address
1000 Tavern Rd Ste 300
Martinsburg, WV 25401-2853
Phone (304) 263-6165
Other practice location 1
1000 Tavern Rd Ste 300
Martinsburg, WV 25401-2853
Phone (304) 263-6165
Other practice location 2
19638 Leitersburg Pike Ste 204
Hagerstown, MD 21742-1518
Phone (240) 850-3210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV, VA, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Tavern Rd
Suite 300
Martinsburg, WV 25401-2853
Phone (304) 263-6165
1839 Plaza Dr
Winchester, VA 22601-6365
Phone (304) 263-6156
19638 Leitersburg Pike
Suite 204
Hagerstown, MD 21742-1518
Phone (304) 263-6165
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2355 | WV | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meridian Surgery Center LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Winchester, VA
- NPI 1144756768
MD, WV
-
- Ambulatory Surgical Clinic/Center
- Hagerstown, MD
- NPI 1528680865
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winchester, VA
- NPI 1619928017
-
dba Valley Health Laboratories
- Clinical Medical Laboratory
- Winchester, VA
- NPI 1790024909
Hospital
-
dba Berkeley Medical Center
- General Acute Care Hospital
- Martinsburg, WV
- NPI 1457389249
-
- Medicare Defined Swing Bed Hospital Unit
- Ranson, WV
- NPI 1104242569
-
dba Jefferson Medical Center
- Critical Access Hospital
- Ranson, WV
- NPI 1891722377
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1659835072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 TAVERN RD STE 300",
"city": "MARTINSBURG",
"state": "WV",
"postal_code": "254012853",
"telephone_number": "304-263-6165",
"fax_number": "304-263-6536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1839 W PLAZA DR",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226016365",
"telephone_number": "540-773-2689",
"fax_number": "304-263-6536"
}
],
"practiceLocations": [
{
"address_1": "1000 Tavern Rd Ste 300",
"address_purpose": "LOCATION",
"city": "Martinsburg",
"state": "WV",
"postal_code": "254012853",
"country_code": "US",
"telephone_number": "304-263-6165",
"fax_number": "304-263-6536",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "19638 Leitersburg Pike Ste 204",
"address_purpose": "LOCATION",
"city": "Hagerstown",
"state": "MD",
"postal_code": "217421518",
"country_code": "US",
"telephone_number": "240-850-3210",
"fax_number": "304-263-6536",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KRISTEN",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-30",
"last_updated": "2022-02-04",
"certification_date": "2020-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WV",
"license": "2355",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "VA",
"license": "0110007062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winchester, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.