Provider Demographics
NPI:1003627522
Name:WILLIAMS, JAMES KURT
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:KURT
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8477 S SUNCOAST BLVD
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34446-5028
Mailing Address - Country:US
Mailing Address - Phone:800-381-0822
Mailing Address - Fax:352-565-5201
Practice Address - Street 1:13875 W 115TH TER
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-7937
Practice Address - Country:US
Practice Address - Phone:800-381-0822
Practice Address - Fax:352-565-5201
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-03050225200000X
MO2016028180225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant