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KENDRICK WILLIAMS MD
NPI 1790572113
Student in an Organized Health Care Education/Training Program in Bristol, TN

Active since April 21, 2025PECOS Enrolled
208 MEDICAL PARK BLVD, BRISTOL, TN 37620(423) 989-4050 Get Directions Write a Review

NPPES record last updated: May 31, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kendrick Williams Md NPPES

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

KENDRICK WILLIAMS MD (NPI 1790572113) is an individual student in an organized health care education/training program in Bristol, Tennessee and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790572113
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameKENDRICK WILLIAMSCredential: MD
Location Address208 MEDICAL PARK BLVDBristol, TN 37620-7343
Mailing Address208 Medical Park BlvdBristol, TN 37620-7343
Phone(423) 989-4050
Sole ProprietorNo
Enumeration DateApril 21, 2025
Last NPPES UpdateMay 31, 2025
NPPES CertifiedMay 31, 2025
✔ NPI 1790572113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
208 MEDICAL PARK BLVD, Bristol, TN 37620
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kendrick 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.

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.

MATTHEW RAYESKI
Student in an Organized Health Care Education/Training Program
208 MEDICAL PARK BLVD
BRISTOL, TN 37620
Sullivan County (423) 989-4050
JARVIS ETHAN PENNINGTON
Student in an Organized Health Care Education/Training Program
208 MEDICAL PARK BLVD
BRISTOL, TN 37620
Sullivan County (423) 989-4050
MADELINE GRACE SHIPLEY
Student in an Organized Health Care Education/Training Program
208 MEDICAL PARK BLVD
BRISTOL, TN 37620
Sullivan County (423) 989-4050
ANDREA LYNNE HOPKINS M.D.
Family Medicine
208 MEDICAL PARK BLVD
BRISTOL, TN 37620
Sullivan County (423) 989-4050
ROMANY AINGEAL NIGHTINGALE
Student in an Organized Health Care Education/Training Program
208 MEDICAL PARK BLVD
BRISTOL, TN 37620
Sullivan County (423) 989-4050
HANNAH BAKER DO
Student in an Organized Health Care Education/Training Program
208 MEDICAL PARK BLVD
BRISTOL, TN 37620
Sullivan County (423) 989-4050
HANNAH KELLER MD
Student in an Organized Health Care Education/Training Program
208 MEDICAL PARK BLVD
BRISTOL, TN 37620
Sullivan County (423) 984-4050
BRANDI KAY DAHL PHARMD
Pharmacist
208 MEDICAL PARK BLVD
BRISTOL, TN 37620
Sullivan County (423) 989-4050

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 1790572113. It was assigned to this individual provider in the NPPES registry on April 21, 2025.

Where is Kendrick Williams located?

Kendrick Williams practices at 208 Medical Park Blvd, Bristol, TN 37620. The listed phone number is (423) 989-4050.

What is Kendrick Williams's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kendrick Williams enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Kendrick Williams was last updated on May 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.