Deactivated NPI 1821112913 Deactivated / Inactive NPI Male Practitioner

Kenneth Lee Williams Sr , RDO

Technician/Technologist - Optician • Modesto, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kenneth Williams Sr has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 16, 2007

NPI Deactivation Date June 20, 2018

Total Practice Duration ~11 Years of Practice (2007 – 2018)

Professional Overview & Biography Verified Profile Summary

Kenneth Williams Sr, RDO was a registered Technician/Technologist - Optician practicing in Modesto, CA. Throughout an active medical career spanning 11 years, Kenneth Williams Sr provided care at the practice location at 1300 SYLVAN AVE until profile deactivation on 2018-06-20.

Practice Location & Contact Primary Location

Practice Address

1300 Sylvan Ave
Suite B-1

Modesto, CA 953551340

Telephone 2095244335

Fax 2095240855

Specialty Benchmarks & Practice Insights

Comparative analytics for Technician/Technologist - Optician in Modesto, CA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 10.2 Yrs

Regional Practice Density

2 Specialists

Practicing in Modesto, CA (356 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Technician/Technologist - Optician Primary Specialty

NUCC Taxonomy Code: 156FX1800X

State License CA 6099

Opticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide which eyeglass frame or contact lenses to buy.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

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NPI Profile Deactivated June 20, 2018

Record deactivated on June 20, 2018

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NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1300 SYLVAN AVE, SUITE B-1, MODESTO, CA 953551340 (Tel: 2095244335)

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Updated Business Mailing Address July 08, 2007

Registered at 1300 SYLVAN AVE, SUITE B-1, MODESTO, CA 953551340 (Tel: 2095244335)

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Provider Name / Credentials Updated July 08, 2007

Recorded as KENNETH WILLIAMS SR, R.D.O.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Technician/Technologist (License #6099 in CA)

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Initial NPI Registration & Enumeration March 16, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1821112913

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 16, 2007

Last Update: July 08, 2007

Deactivation Date: June 20, 2018

Update or Correct Profile

Mailing Address

1300 Sylvan Ave, Suite B-1

Modesto, CA 953551340

Phone: 2095244335

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

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