Donell Williams

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

License

173031 Issued in OH

Practice address

2314 Kelly PL
Lorain, OH 44052-4838

Phone

(440) 246-4616

Fax

(440) 246-1997

NPI assigned

Oct 9, 2020

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

Electronic endpoints 1

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.

• Lorain Urban Minority Alcoholism and Drug Abuse Outreach Program

  • Public Health or Welfare Agency
  • Lorain, OH
  • NPI 1437108032
  NPD

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1013515303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 KELLY PL",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440524838",
            "telephone_number": "440-246-4616",
            "fax_number": "440-246-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 KELLY PL",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440524838",
            "telephone_number": "440-246-4616",
            "fax_number": "440-246-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DONELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "OH",
            "license": "173031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "other",
            "affiliation": "N",
            "address_1": "2314 Kelly Pl",
            "city": "Lorain",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440524838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua James Wilke
• Nautika Germaine Wilkerson
• Diane M Wilkins, RN
• Judith Willey, L.I.S.W.
• Bradie A Williams
• Elizabeth Annette Williams
• Helen Marie Williams
• Janielle Williams
• Jaree Williams
• Jazzmine Williams

• Prevention Professional in Lorain, OH
• Providers in Lorain, OH by specialty
• Prevention Professional in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.