DR. KELLIE NICOLE WILLIAMS M.D.
NPI 1629238787
Pediatrics - Pediatric Emergency Medicine in San Antonio, TX

Q: What is Kellie Williams's NPI number?

The NPI number for Kellie Williams is 1629238787. It was assigned to this individual provider in the NPPES registry on June 12, 2008. The provider is also known as Dr. Kellie Nicole Goforth M.D..

Q: What is Kellie Williams's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Q: When was this NPI record last updated?

The NPPES record for Kellie Williams was last updated on April 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 12, 2008PECOS Enrolled

333 N SANTA ROSA, SAN ANTONIO, TX 78207(210) 704-3030 Get Directions Write a Review

NPPES record last updated: April 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 3, 2026, Jan 6, 2021 (2 updates tracked since 2021).

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About Dr. Kellie Nicole Williams M.d. NPPES

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

DR. KELLIE NICOLE WILLIAMS M.D. (NPI 1629238787) is an individual pediatric emergency medicine provider in San Antonio, Texas, licensed in Virginia (0101249447) and active in the NPI registry since June 2008. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1629238787

Entity TypeIndividualFemale

Primary Taxonomy2080P0204X

Provider Legal NameDR. KELLIE NICOLE WILLIAMSCredential: M.D.

Location Address333 N SANTA ROSASan Antonio, TX 78207-3108

Mailing Address315 N San Saba Ste 1135San Antonio, TX 78207-3255 · (210) 704-3321

Phone(210) 704-3030

Sole ProprietorNo

Enumeration DateJune 12, 2008

Last NPPES UpdateApril 3, 20262 updates tracked since enumeration

NPPES CertifiedApril 3, 2026

✔ NPI 1629238787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0204X

License✔ Licensed in VA · 0101249447

Definition

A pediatrician who has special qualifications to manage emergencies in infants and children.

Also ListedPediatricsTaxonomy 208000000X · License Q3465 (TX)

333 N SANTA ROSA, San Antonio, TX 78207

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Other Names 1

Former Name (1)Dr. Kellie Nicole Goforth M.d.

Secondary Practice Locations 2

Location 1315 N San Saba Ste 11San Antonio, TX 78207-3154 · Phone (210) 704-3321

Location 2601 Childrens LnNorfolk, VA 23507-1910 · Phone (757) 668-7000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kellie Nicole Williams M.d. 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.

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.

LATHA PRASANNAN MD

Pediatrics (Pediatric Hematology-Oncology)