Individual provider Active NPI

Mary Ellen Williams

  • Registered Nurse
  • Surprise, AZ
National Provider Identifier
1013783414
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN200525 Issued in AZ
Practice address
15802 N Parkview PL
Surprise, AZ 85374-7466
Phone
(623) 876-7000
NPI assigned
Nov 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN200525 AZ Primary

Addresses

Primary practice location

15802 N Parkview PL
Surprise, AZ 85374-7466

Mailing address

17565 W Windrose Dr
Surprise, AZ 85388-5645
Phone (313) 304-9476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN200525AZMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1013783414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17565 W WINDROSE DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853885645",
            "telephone_number": "313-304-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15802 N PARKVIEW PL",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747466",
            "telephone_number": "623-876-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN200525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.