NPIMap

Individual provider Active NPI

Keith Anthony Williams, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Port Charlotte, FL
National Provider Identifier
1689865891
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
ME0066000 Issued in FL
Practice address
4265 Laura Street
Port Charlotte, FL 33980
Phone
(941) 764-7117
Fax
(941) 764-1049
NPI assigned
Aug 5, 2007
Last updated
Jan 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X ME0066000 FL Primary

Addresses

Primary practice location

4265 Laura Street
Port Charlotte, FL 33980

Mailing address

PO Box 510816
Punta Gorda, FL 33951-0816
Phone (941) 764-7117

Other identifiers 1

IdentifierTypeStateIssuer
262297100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110330000668 FL Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 0941483804 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
University of Pittsburgh School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

450 Shreve St
Punta Gorda, FL 33950-3325
Phone (941) 639-8771

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
M & H Med Housecalls, LLC CurrentSince Feb 20, 2024 Accepting new patients
Keith Williams LLC Pain Medicine CurrentSince Jul 17, 2023 Accepting new patients
Florida Department of Veterans Affairs PastSince Apr 8, 2025 Accepting new patients

Locations

1407 Viscaya Pkwy
Ste 2
Cape Coral, FL 33990
Phone (239) 772-0111

450 Shreve St
Punta Gorda, FL 33950
Phone (863) 693-1000

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Douglas Jacobson State Veterans' Nursing HomePort Charlotte, FL, CCN 106059 Skilled nursing facility Adp of the SNF Apr 8, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1689865891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510816",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339510816",
            "telephone_number": "941-764-7117",
            "fax_number": "941-764-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4265 LAURA STREET",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33980",
            "telephone_number": "941-764-7117",
            "fax_number": "941-764-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KEITH",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "ME0066000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262297100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.