Individual provider Active NPI

Roslyn Williams, NP

  • Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1033526363
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704232829 Issued in MI
Practice address
315 E Eisenhower Pkwy
Suite 7
Ann Arbor, MI 48108-3350
Phone
(734) 222-8200
Fax
(734) 222-8202
NPI assigned
Jul 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704232829 MI Primary

Addresses

Primary practice location

315 E Eisenhower Pkwy
Suite 7
Ann Arbor, MI 48108-3350

Mailing address

9501 E Highland Rd
Apt 277
Howell, MI 48843-5002
Phone (313) 243-4425

Other identifiers 1

IdentifierTypeStateIssuer
4704232829OtherMINP LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140818002255 MI Practitioner - Nurse Practitioner 5395962104 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Clinical LLC Nurse Practitioner CurrentSince Apr 11, 2019 Accepting new patients
Vpa PC CurrentSince Oct 1, 2023 Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Oct 1, 2023 Accepting new patients
Great Health Medical Mi PC CurrentSince Dec 23, 2024 Accepting new patients
Roslyn Williams LLC Current Accepting new patients
Paragon Clinical Midwest, LLC Nurse Practitioner Past Accepting new patients
Gerald F Daneshvar MD PLLC PastSince Jan 17, 2019 Accepting new patients
Integrated Physician Solutions PC PastSince Oct 1, 2021 Accepting new patients

Locations

1385 E Empire Ave
Benton Harbor, MI 49022
Phone (269) 925-0033

3011 N Center Rd
Flint, MI 48506
Phone (710) 736-0600

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

407 Willoughby Ave
Brooklyn, NY 11205
Phone (212) 201-1252

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1033526363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 E HIGHLAND RD",
            "address_2": "APT 277",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488435002",
            "telephone_number": "313-243-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E EISENHOWER PKWY",
            "address_2": "SUITE 7",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083350",
            "telephone_number": "734-222-8200",
            "fax_number": "734-222-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROSLYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704232829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE NUMBER",
            "identifier": "4704232829",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.