NPIMap

Individual provider Active NPI

Kenneth Williams, MD

  • Internal Medicine Physician
  • Holly Springs, MS
National Provider Identifier
1851480974
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
13813 Issued in MS
Practice address
1938 Crescent Meadow Drive
Holly Springs, MS 38635-3238
Phone
(662) 252-1599
Fax
(662) 252-1986
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13813 MS Primary

Addresses

Primary practice location

1938 Crescent Meadow Drive
Holly Springs, MS 38635-3238

Mailing address

538 J M Ash Dr
Holly Springs, MS 38635-3238
Phone (662) 252-1599

Other identifiers 1

IdentifierTypeStateIssuer
0011155MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20050207000385 MS Practitioner - Internal MedicinePractitioner - Emergency Medicine 1850364191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Meharry Medical College School of Medicine, 1986
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Alliance Healthcare System, IncGroup PAC ID 2961489547, 5 clinicians

Practice addresses (Care Compare)

1938 Crescent Meadow Dr
Holly Springs, MS 38635-7419
Phone (662) 252-1599

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Tupelo, MS, CCN 257303
  • Alliance Healthcare Hospice Hospice, Holly Springs, MS, CCN 251644
  • Alliance Healthcare System, Inc Hospital, Holly Springs, MS, CCN 250174
  • Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
  • Baptist Memorial Hospital Union County Hospital, New Albany, MS, CCN 250006
  • Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13813MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Healthcare System Inc CurrentSince Feb 1, 2005 Accepting new patients
Alliance Healthcare System, Inc CurrentSince Mar 19, 1998 Accepting new patients
Alliance Healthcare System, Inc Past Accepting new patients
Alliance Healthcare System, Inc Past Accepting new patients
Alliance Healthcare Hospice PastSince Aug 31, 2017 Accepting new patients
Alliance Healthcare System, Inc Past Accepting new patients

Locations

1430 Highway 4 E
Holly Springs, MS 38635
Phone (662) 252-1212

538 J M Ash Dr
Holly Springs, MS 38635
Phone (662) 252-1599

1938 Crescent Meadows Dr
Holly Springs, MS 38635
Phone (662) 252-1599

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/allihcs-9d312177

Ownership & related parties

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Progressive Health of Holly SpringsHolly Springs, MS, CCN 250174 Hospital 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee (100%)		 Nov 1, 1999
Nov 1, 1999
Alliance Healthcare System, IncHolly Springs, MS, CCN 25U174 Hospital 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee		 Nov 1, 1999
Nov 1, 1999
Alliance Healthcare System, IncHolly Springs, MS, CCN 25S174 Hospital 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee (100%)		 Nov 1, 1999
Nov 1, 1999
Alliance Healthcare HospiceHolly Springs, MS, CCN 251644 Hospice 5% Or Greater Direct Ownership Interest (100%) Aug 31, 2017
Williams Medical ClinicHolly Springs, MS, CCN 258528 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director
W-2 Managing Employee		 Nov 1, 1999
Nov 1, 1999
May 19, 2005
Jul 1, 2005
Panola Medical CenterBatesville, MS, CCN 258516 Rural health clinic 5% Or Greater Indirect Ownership Interest (50%) Apr 22, 2023
Panola Medical CenterBatesville, MS, CCN 258517 Rural health clinic 5% Or Greater Indirect Ownership Interest (50%) Apr 22, 2023

Owned or controlled facilities with NPI records 7

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

Organizations & group practices 6

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 6

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1851480974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 J M ASH DR",
            "city": "HOLLY SPRINGS",
            "state": "MS",
            "postal_code": "386353238",
            "telephone_number": "662-252-1599",
            "fax_number": "662-252-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 CRESCENT MEADOW DRIVE",
            "city": "HOLLY SPRINGS",
            "state": "MS",
            "postal_code": "386353238",
            "telephone_number": "662-252-1599",
            "fax_number": "662-252-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KENNETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "13813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011155",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, MS

Sources for this page

Verify at the official NPI Registry.