Physician Compare National (NPI:1902030042)

HEALTHCARE PROVIDER: KELLI WONG WILLIAMS M.D., M.P.H.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1902030042
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274841291
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150924001587
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WILLIAMS
	Individual professional last name
Provider First Name	KELLI
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TULANE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	ALLERGY/IMMUNOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PEDIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PEDIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	UNIVERSITY MEDICAL ASSOCIATES
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6305758574
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	1021
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	171 ASHLEY AVE
	Group Practice or individual's line 1 address
City	CHARLESTON
	Group Practice or individual's city
State	SC
	Group Practice or individual's state
Zip Code	294258908
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8437921414
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	420004
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MUSC MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y