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KENDRICK J WILLIAMS MD
NPI 1104494798
Pediatrics in Lake Saint Louis, MO

Active since June 11, 2021PECOS Enrolled
100 MEDICAL PLZ, LAKE SAINT LOUIS, MO 63367(636) 625-5300 Get Directions Write a Review

NPPES record last updated: January 28, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 10, 2024, Jun 11, 2021 (2 updates tracked since 2021).

About Kendrick J Williams Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENDRICK J WILLIAMS MD (NPI 1104494798) is an individual pediatrics provider in Lake Saint Louis, Missouri, licensed in Missouri (2022039727) and active in the NPI registry since June 2021. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1104494798
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameKENDRICK J WILLIAMSCredential: MD
Location Address100 MEDICAL PLZLake Saint Louis, MO 63367-1366
Mailing Address1205 Foxview TerBallwin, MO 63011-4315
Phone(636) 625-5300
Sole ProprietorNo
Enumeration DateJune 11, 2021
Last NPPES UpdateJanuary 28, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 28, 2025
✔ NPI 1104494798 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MO · 2022039727
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
100 MEDICAL PLZ, Lake Saint Louis, MO 63367
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1300 1st Capitol DrSaint Charles, MO 63301-2844 · Phone (636) 947-5000
Location 212303 De Paul DrBridgeton, MO 63044-2512 · Phone (314) 344-6000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kendrick J Williams Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Kendrick Williams reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ssm Health Care St. Louis
0.1 mi
Emergency Medical Services
100 MEDICAL PLZ
Lake St Louis, MO 63367
  • Reassigned Medicare billing, Missouri enrollment
  • 741 clinicians in this Medicare group
NPI 1538113097 (636) 625-5200
Ssm Cardinal Glennon Childrens Hospital
20 mi
Pediatrics
2927 S . KINGS HIGHWAY BLVD
Saint Louis, MO 63139
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Ssm Cardinal Glennon Children's Hospital
  • 76 clinicians in this Medicare group
NPI 1073568226 (314) 268-4070

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63367 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VICTORIA LYNN HINES NP
Nurse Practitioner
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-5200
LAKE FOREST EMERGENCY GROUP LLC
Emergency Medicine
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-5200
EVE WEINDELL BARNOSKI LPTA
Physical Therapy Assistant
100 MEDICAL PLZ
LAKE SAINT LOUIS, MO 63367
St. Charles County (636) 485-7608
JOSHUA HARKLESS MD
Emergency Medicine
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-5300
MELISSA COLLEEN HYNES MHS, CCC-SLP
Speech-Language Pathologist
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 755-3997
AKIKO OKABE AGACNP
Nurse Practitioner (Acute Care)
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (314) 317-0600
YUNHEE CHOI CRUSE CNP, FNP-BC
Nurse Practitioner (Family)
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-5200
JIAJING WANG
Pharmacist
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-5200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kendrick Williams's NPI number?

The NPI number for Kendrick Williams is 1104494798. It was assigned to this individual provider in the NPPES registry on June 11, 2021.

Where is Kendrick Williams located?

Kendrick Williams practices at 100 Medical Plz, Lake Saint Louis, MO 63367. The listed phone number is (636) 625-5300.

What is Kendrick Williams's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kendrick Williams enrolled in Medicare?

Yes. Kendrick Williams is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kendrick Williams's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kendrick Williams reassigns Medicare benefits to 2 organizations: Ssm Health Care St. Louis (Lake St Louis, MO) and Ssm Cardinal Glennon Childrens Hospital (Saint Louis, MO). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kendrick Williams's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kendrick Williams accept?

Health plans from Anthem Blue Cross and Blue Shield list Kendrick Williams as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kendrick Williams was last updated on January 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.