Active NPI
Kenneth Dean Williams, DO
- General Practice Physician
- Mansfield, OH
National Provider Identifier
1962622738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 34-00-5450
- Practice address
- 1001 Olivesburg Rd
Mansfield, OH 44905-1228 - Phone
- (419) 526-2100
- Fax
- (419) 521-2815
- NPI assigned
- Apr 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 34-00-5450 | OH | Primary |
Addresses
Primary practice location
1001 Olivesburg Rd
Mansfield, OH 44905-1228
Mailing address
448 Five Points Rd.
Mansfield, OH 44903
Phone (419) 525-7391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962622738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "448 FIVE POINTS RD.",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "44903",
"telephone_number": "419-525-7391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 OLIVESBURG RD",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449051228",
"telephone_number": "419-526-2100",
"fax_number": "419-521-2815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KENNETH",
"middle_name": "DEAN",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "OH",
"license": "34-00-5450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.