NPIMap

Individual provider Active NPI

Mark E Williams, MD

  • Family Medicine Physician
  • Beavercreek, OH
National Provider Identifier
1891894408
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35065595 Issued in OH
Practice address
2400 Lakeview Dr Ste 100
Beavercreek, OH 45431-2581
Phone
(937) 429-4369
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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 35065595 OH Primary

Addresses

Primary practice location

2400 Lakeview Dr Ste 100
Beavercreek, OH 45431-2581

Mailing address

3170 Kettering Blvd BLDG B2
Moraine, OH 45439-1924
Phone (937) 991-3188

Other identifiers 1

IdentifierTypeStateIssuer
0139451MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
RESTful URL mwilliams3555@direct.premierhealth.com

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
I20090811000012 OH Practitioner - Family Practice 9032263058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Cincinnati College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians

Practice addresses (Care Compare)

111 Harbert Dr
Beavercreek, OH 45440-5117
Phone (937) 208-7575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35065595OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Urgent Care, Inc. CurrentSince Sep 9, 2019 Accepting new patients
Mvhe Inc CurrentSince Oct 10, 2016 Accepting new patients
Mvhe Inc Family Medicine CurrentSince Oct 10, 2016 Accepting new patients
Alliance Physicians Inc Family Medicine Past Accepting new patients
Mvhe Inc Past Accepting new patients

Locations

2400 Lakeview Dr
Ste 100
Beavercreek, OH 45431
Phone (937) 429-4369

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

111 Harbert Dr
Dayton, OH 45440
Phone (937) 208-7575

8 Prestige Plaza Dr
Ste 107
Miamisburg, OH 45342
Phone (937) 208-6871

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

1843 W Main St
Troy, OH 45373
Phone (937) 208-4120

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 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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1891894408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 KETTERING BLVD BLDG B2",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391924",
            "telephone_number": "937-991-3188",
            "fax_number": "937-208-7590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 LAKEVIEW DR STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312581",
            "telephone_number": "937-429-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35065595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0139451",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "mwilliams3555@direct.premierhealth.com",
            "affiliation": "N",
            "address_1": "2400 Lakeview Dr Ste 100",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454312581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.