Individual provider Active NPI

Keary Robert Williams Jr., MD

  • Surgery Physician
  • Knoxville, TN
National Provider Identifier
1912958059
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD41529 Issued in TN
Practice address
9430 Park West Blvd Ste 310
Knoxville, TN 37923-4203
Phone
(865) 694-9676
Fax
(865) 588-3742
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD41529 TN Primary

Addresses

Primary practice location

9430 Park West Blvd Ste 310
Knoxville, TN 37923-4203

Mailing address

PO Box 52948
Knoxville, TN 37950-2948
Phone (865) 306-5675

Other identifiers 1

IdentifierTypeStateIssuer
Q002888MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070411000076 TN Practitioner - General Surgery 0446355010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Virginia School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Surgical Associates PLLCGroup PAC ID 1254224181, 61 clinicians

Practice addresses (Care Compare)

9430 Parkwest Blvd
Suite 310
Knoxville, TN 37923-4203
Phone (865) 690-5263

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.3 of 100Reported as group
Quality
64.09
Promoting interoperability
98
Improvement activities
40
Cost
77.69

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD41529TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Surgical Associates, PLLC Surgery CurrentSince Sep 29, 2006 Accepting new patients
Premier Surgical Associates, PLLC Surgery CurrentSince Sep 29, 2006 Accepting new patients
Parkwest Medical Center Past Accepting new patients

Locations

9330 Park West Blvd
Ste 508
Knoxville, TN 37923
Phone (865) 691-1115

9430 Park West Blvd
Ste 310
Knoxville, TN 37923
Phone (865) 984-3413

6408 Papermill Dr
Ste 220
Knoxville, TN 37919
Phone (865) 306-5675

10810 Parkside Dr
Ste 305
Knoxville, TN 37934
Phone (865) 392-3971

6408 Papermill Dr
Knoxville, TN 37919
Phone (865) 306-5680

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71045

Organizations & group practices 3

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 4

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1912958059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52948",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502948",
            "telephone_number": "865-306-5675",
            "fax_number": "865-584-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 PARK WEST BLVD STE 310",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234203",
            "telephone_number": "865-694-9676",
            "fax_number": "865-588-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KEARY",
        "middle_name": "ROBERT",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD41529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q002888",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.