Grace Willams

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

RN43918 Issued in NV

Practice address

528 E Oakey Blvd # 110
Las Vegas, NV 89104-1403

Phone

(170) 268-6337

NPI assigned

Oct 10, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• JPN Holdings Corp

  • In Home Supportive Care Agency
  • Las Vegas, NV
  • NPI 1740894096

  Personal Care Attendant

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1003531286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 E OAKEY BLVD # 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041403",
            "telephone_number": "170-268-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 E OAKEY BLVD # 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041403",
            "telephone_number": "170-268-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLAMS",
        "first_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NV",
            "license": "RN43918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Izaya Wilks
• Kristopher Wilks
• Treveon Wilks
• Ida Bernadette Plaza Will, APN-C
• Jeremy Will, RD/LD
• Shara Willams
• Dawn M. Willard, APN
• Jaden Willard, DMD
• Joshua Willard
• Quianna Willard, OTR/L

• Administrator Registered Nurse in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Administrator Registered Nurse in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.