DR. AMANDA KAY WILLIAMS (DO) – Geriatric Medicine (Family Medicine) Physician, NPI 1104147669

DR. AMANDA KAY WILLIAMS (DO) is a healthcare provider. based in London, Ohio. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 2012-01741 (NC). The NPI Number for DR. AMANDA KAY WILLIAMS (DO) is 1104147669

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
DR. AMANDA KAY WILLIAMS (DO)
NPI
1104147669
Phone
(740) 845-7500
Address
55 PARK AVE
Enumeration Date
18 June 2010
Last Update Date
16 September 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7404553304
Graduation Year
2010 (16 years ago)
PAC ID
9436396512
Group Practice PAC ID
8628232469
Professional Enrollment ID
I20141219000614
Address ID
OH437016172ZA200XXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:15State licenses:2Digital endpointsOther names

4,431 FAMILY PRACTICE in OH

Provider Addresses for DR. AMANDA KAY WILLIAMS (DO)

  • 55 PARK AVE

    STE 275

    LONDON, OH 431401170

    Phone: (740) 845-7500

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $111.

Total Amount is formed as General ($111) + Research ($0) + Ownership ($0) = $111.

Last reported payment date: 2024-11-13 • Largest payer in this snapshot: ABBVIE INC. ($50).

Total Amount

$111

General + Research + Ownership

Payments

7

Total payment records

General Amount

$111

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-13

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-12-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-12-31 (891 days ago).

Enrollment records

1

Earliest due date

2023-12-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141219000614IFamily PracticeOH2023-12-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes188114$0
99306Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes139120$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit125125$0
99215Established patient office or other outpatient visit, 40-54 minutes10872$0
G0444Annual depression screening, 5 to 15 minutes8888$0
View full utilization report →

Insurance plans in this area (ZIP 43140)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8628232469View full group profile
NameSpecialtyState
Internal MedicineLA
Family PracticeOH
Nurse PractitionerOH
Family PracticeOH
Internal MedicineOH
Family PracticeOH
Sports Medicine, Family Practice, Family PracticeOH
Family PracticeOH
Nurse PractitionerOH
Nurse PractitionerOH

Reviews

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Frequently asked questions

Can I cross-check DR. AMANDA KAY WILLIAMS (DO) using NPI 1104147669?
NPI 1104147669 belongs to DR. AMANDA KAY WILLIAMS (DO); compare other details if you need extra assurance.
Active or inactive — what applies to DR. AMANDA KAY WILLIAMS (DO)?
You should see DR. AMANDA KAY WILLIAMS (DO) as active in CMS-hosted NPPES data.
How would a patient describe DR. AMANDA KAY WILLIAMS (DO)'s focus?
For DR. AMANDA KAY WILLIAMS (DO), the primary taxonomy reads as Geriatric Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. AMANDA KAY WILLIAMS (DO)?
Travel planning: use London, Ohio as the reference point for DR. AMANDA KAY WILLIAMS (DO), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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