Amanda Dawn Williams, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2007016867 Issued in MO

Practice address

805 N 36TH St Ste B
Saint Joseph, MO 64506-2954

Phone

(816) 396-6026

Fax

(816) 398-6896

NPI assigned

Apr 8, 2008

Last updated

Aug 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.williams@direct.mymlc.com

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.

• Peacock Pediatrics, LLC

  • Pediatrics Physician
  • Saint Joseph, MO
  • NPI 1598399784
  NPD Authorized official
• Children's Mercy - Peacock Pediatrics, Inc

  • Pediatrics Physician
  • Saint Joseph, MO
  • NPI 1356090880
  NPD

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1902079189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N 36TH ST STE B",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062954",
            "telephone_number": "816-396-6026",
            "fax_number": "816-398-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N 36TH ST STE B",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062954",
            "telephone_number": "816-396-6026",
            "fax_number": "816-398-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AMANDA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2007016867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902079189",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200642020A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tricia R. Wilcox, M.S ED CCC-SLP
• Wildflower Riverhouse LLC (Thomas III)
• Jeri Jean Wilds
• Kristine M Wilfong, CRNA
• Megan Renee Wilkinson, AU.D.
• Billie J Williams
• Devon Reyandre Williams
• Rhea J Williams, FNP
• Barbara Ann Willis, MSW,LCSW
• Laura Willoughby, PMHNP-BC

• Pediatrics Physician in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.