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Deactivated NPI 1710965249 Deactivated / Inactive NPI Female Practitioner

Dr. Beverly A Williams , MD

Personal Emergency Response Attendant • Kettering, OH

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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, Dr. Beverly Williams has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 05, 2006
NPI Deactivation Date September 04, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Beverly Williams, MD was a registered Personal Emergency Response Attendant practicing in Kettering, OH. Throughout an active medical career spanning 19 years, Dr. Williams provided care at the practice location at 3535 SOUTHERN BLVD until profile deactivation on 2025-09-04.

Historical Medicare Part B clinical services included emergency department visit for life threatening or functioning severity, routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only, emergency department visit with moderate level of medical decision making. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

3535 Southern Blvd

Kettering, OH 454291221

Telephone 9373958166
Associated Practice Facility / Clinic
🏢 Kettering Physiatrists, Inc. Facility NPI 1902893035

Specialty Benchmarks & Practice Insights

Comparative analytics for Personal Emergency Response Attendant in Kettering, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 39.0 Yrs
Regional Practice Density
3 Specialists

Practicing in Kettering, OH (53 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
84.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity
107 107 $1191.00 $181.94
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
83 79 $49.00 $8.32
99284 Emergency department visit with moderate level of medical decision making
30 30 $771.00 $124.44
99283 Emergency department visit with low level of medical decision making
21 21 $516.00 $73.12

Medical Specialties & State Licenses

Personal Emergency Response Attendant Primary Specialty

NUCC Taxonomy Code: 146D00000X

State License OH 35083040

Individuals that are specially trained to assist patients living at home with urgent/emergent situations. These individuals must be able to perform CPR and basic first aid and have sufficient counseling skills to allay fears and assist in working through processes necessary to resolve the crisis. Functions may include transportation to various facilities and businesses, contacting agencies to initiate remediation service or providing reassurance.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Annemarie Underwood , PA-C

Physician Assistant

NPI 1003551920

Physician Assistant (Certified)

Dr. Richard Garrison , MD

Emergency Medicine

NPI 1013994300

Doctor of Medicine (M.D.)

Zachary Carlisle , PA

Physician Assistant

NPI 1023994035

Physician Assistant

NPI 1033837091

MPAS, Physician Assistant (Certified)

Dr. Matthew Kiefaber , MD

Emergency Medicine

NPI 1043268519

Doctor of Medicine (M.D.)

Dr. Mitchell Garey , DO

Emergency Medicine

NPI 1053052860

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

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

14 Historical Events
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NPI Profile Deactivated September 04, 2025

Record deactivated on September 04, 2025

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 20, 2025

Emergency Medicine (License #35083040 in OH)

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Updated Business Mailing Address September 06, 2019

Registered at 3131 NEWMARK DR STE 220, MIAMISBURG, OH 453425400 (Tel: 9374364658)

NPI Profile Active March 17, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location March 17, 2018

Registered at 3535 SOUTHERN BLVD, KETTERING, OH 454291221 (Tel: 9373958166)

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Updated Business Mailing Address March 17, 2018

Registered at 8280 YANKEE ST, CENTERVILLE, OH 454581806 (Tel: 9374364658)

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Provider Name / Credentials Updated March 17, 2018

Recorded as BEVERLY WILLIAMS, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2018

Personal Emergency Response Attendant (License #35083040 in OH)

NPI Profile Active June 03, 2015

NPI status registered as active in NPPES database

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Updated Practice Location June 03, 2015

Registered at 3535 SOUTHERN BLVD, KETTERING, OH 454291221 (Tel: 9373958166)

📍
Updated Business Mailing Address June 03, 2015

Registered at 8280 YANKEE ST, CENTERVILLE, OH 454581806 (Tel: 9374364658)

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Provider Name / Credentials Updated June 03, 2015

Recorded as BEVERLY WILLIAMS, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 03, 2015

Personal Emergency Response Attendant (License #35083040 in OH)

🟢
Initial NPI Registration & Enumeration January 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710965249
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 05, 2006
Last Update: June 03, 2015
Deactivation Date: September 04, 2025

Mailing Address

8280 Yankee St

Centerville, OH 454581806

Phone: 9374364658

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

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.