NPIMap

Individual provider Active NPI

Stephanie L Williams, MD

  • Family Medicine Physician
  • Maumee, OH
National Provider Identifier
1669632576
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35094981 Issued in OH
Practice address
5705 Monclova Rd
Maumee, OH 43537-1875
Phone
(419) 893-3321
Fax
(419) 897-1311
NPI assigned
Jun 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35094981 OH Primary

Addresses

Primary practice location

5705 Monclova Rd
Maumee, OH 43537-1875

Mailing address

5705 Monclova Rd
Maumee, OH 43537-1875
Phone (419) 893-3321

Other identifiers 1

IdentifierTypeStateIssuer
0050613MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110810000513 OH Practitioner - Family Practice 5496924391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

650 Beaver Creek Cir
Suite 130
Maumee, OH 43537-1753
Phone (419) 891-6210

Hospital & facility affiliations

  • Ohioans Home Healthcare, Inc Home health agency, Perrysburg, OH, CCN 368247
  • Elara Caring Home health agency, Toledo, OH, CCN 367730
  • Ohio Living Home Health Greater Toledo Home health agency, Toledo, OH, CCN 367530
  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35094981OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Mar 30, 2023 Accepting new patients
Promedica Central Physicians Family Medicine CurrentSince Mar 30, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

650 Beaver Creek Cir
Ste 130
Maumee, OH 43537
Phone (419) 891-6210

5705 Monclova Rd
Maumee, OH 43537
Phone (419) 893-3321

5901 Monclova Rd
Maumee, OH 43537
Phone (419) 893-5911

1620 Brigham Dr
Ste 220
Perrysburg, OH 43551
Phone (567) 585-0265

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Interoperability endpoints

  • Direct secure messaging: swilliams32342@direct.promedica.org

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1669632576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 MONCLOVA RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371875",
            "telephone_number": "419-893-3321",
            "fax_number": "419-897-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 MONCLOVA RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371875",
            "telephone_number": "419-893-3321",
            "fax_number": "419-897-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35094981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050613",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.