Juan Deon Williams

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

BA11300072 Issued in IN

Practice address

2843 E State Blvd
Fort Wayne, IN 46805-4732

Phone

(260) 750-2889

NPI assigned

Jul 25, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Art-Cut-Tects Barbershop & Supplies LLC

  • Point of Service
  • Fort Wayne, IN
  • NPI 1881320737
  NPD Authorized official

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1003542937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 E BERRY ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468033905",
            "telephone_number": "260-418-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2843 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054732",
            "telephone_number": "260-750-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JUAN",
        "middle_name": "DEON",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "IN",
            "license": "BA11300072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Williams
• Felicia M Williams
• Jeffrey S. Williams, PA-C
• Jennifer Michele Williams, DC
• John I Williams, MD
• Judith L Williams, PSY.D.
• Keegan Williams
• Kishyla Williams
• Kyra Williams
• Logan Alan Williams, CRNA

• Personal Care Attendant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Personal Care Attendant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.