Active NPI
Shadrienne Nikeia Williams
- Medical Physician Assistant
- Dover, DE
National Provider Identifier
1023285509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 748 S New St
Suites C & D
Dover, DE 19904-3573 - Phone
- (302) 734-3227
- Fax
- (303) 734-0391
- NPI assigned
- May 13, 2008
- Last updated
- Mar 31, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | DE | Primary |
Addresses
Primary practice location
748 S New St
Suites C & D
Dover, DE 19904-3573
Mailing address
4923 Ogletown Stanton Rd
Suite 200
Newark, DE 19713-2081
Phone (302) 225-0451
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023285509 | Medicaid | DE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
701 N Clayton St
Suite 401
Wilmington, DE 19805-3165
Phone (302) 421-9411
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Newark, DE
- NPI 1407805203
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459382400000",
"number": "1023285509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4923 OGLETOWN STANTON RD",
"address_2": "SUITE 200",
"city": "NEWARK",
"state": "DE",
"postal_code": "197132081",
"telephone_number": "302-225-0451",
"fax_number": "302-225-0472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "748 S NEW ST",
"address_2": "SUITES C & D",
"city": "DOVER",
"state": "DE",
"postal_code": "199043573",
"telephone_number": "302-734-3227",
"fax_number": "303-734-0391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "SHADRIENNE",
"middle_name": "NIKEIA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-13",
"last_updated": "2016-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "DE",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1023285509",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dover, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.