Active NPI
Joah Williams, PHD
- Clinical Psychologist
- Kansas City, MO
National Provider Identifier
1962928077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2015027929
- Practice address
- 300 W 19TH Ter
Kansas City, MO 64108-2026 - Phone
- (816) 404-5991
- NPI assigned
- Aug 21, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2015027929 | MO | Primary |
Addresses
Primary practice location
300 W 19TH Ter
Kansas City, MO 64108-2026
Mailing address
11303 N Jefferson St
Kansas City, MO 64155-1072
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 490046349 | Medicaid | MO |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015027929 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608681600000",
"number": "1962928077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11303 N JEFFERSON ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641551072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W 19TH TER",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641082026",
"telephone_number": "816-404-5991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JOAH",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-21",
"last_updated": "2020-12-23",
"certification_date": "2020-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2015027929",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "490046349",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.