Jill Annette Williams, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD00041527 Issued in WA

Practice address

400 S 43Rd St
Renton, WA 98055-5714

Phone

(425) 251-5165

Fax

(425) 656-4028

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4

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.

• The Polyclinic PLLC

  • Audiologist
  • Seattle, WA
  • NPI 1174594634
  Medicare reassignment NPD
• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574

  Physical Medicine & Rehabilitation

  Medicare reassignment NPD
• The Polyclinic

  • Ambulatory Surgical Clinic/Center
  • Seattle, WA
  • NPI 1073944039
  NPD
• The Polyclinic PLLC

  • Durable Medical Equipment & Medical Supplies
  • Tacoma, WA
  • NPI 1831411487
  NPD

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500854400000",
    "number": "1962628107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34876",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241876",
            "telephone_number": "425-251-5165",
            "fax_number": "425-656-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-251-5165",
            "fax_number": "425-656-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JILL",
        "middle_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2017-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081H0002X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Hospice and Palliative Medicine",
            "state": "WA",
            "license": "MD00041527",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD00041527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "339491",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #  VM",
            "identifier": "4659WI",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8369886",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN  VM",
            "identifier": "US5533762",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Darlene Wilke, CPHT
• Leah Marie Wilkinson Keylard, MA, CCC A
• William Ronald Wilkinson, ED.D.
• Derrik Williams, DC
• Elisa K Williams, ARNP
• Jim O Williams, MA
• Juanita Williams, HEALTH COACH
• Keoni L Williams
• Laura Williams, MHCA
• Linda S Williams

• Physical Medicine & Rehabilitation Physician in Renton, WA
• Providers in Renton, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.