Shane Michael Williams, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11405599-1205 Issued in UT

Practice address

375 S Chipeta Way Ste a
Salt Lake City, UT 84108-1261

Phone

(440) 263-8777

NPI assigned

Apr 3, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1871099309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 S CHIPETA WAY STE A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081261",
            "telephone_number": "801-581-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S CHIPETA WAY STE A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081261",
            "telephone_number": "440-263-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHANE",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11405599-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Vincent Williams
• S. Elizabeth Williams, APRN
• Sarah Elizabeth Williams, NNP
• Scott Dean Williams, M.D.
• Shade Atkinson Williams, M.D.
• Stephanie Williams
• Tanya Maile Williams, MD
• Taylor Payton Williams
• Tristan J Williams
• Diantha Williamson, M.D.

• Family Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.