Individual provider Active NPI

Leyanna Marie Williams, RN

  • Registered Nurse
  • Revere, MA
National Provider Identifier
1063931327
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN2296332 Issued in MA
Practice address
454 Broadway
Revere, MA 02151-3034
Phone
(781) 485-8200
NPI assigned
Sep 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

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 RN2296332 MA Primary

Addresses

Primary practice location

454 Broadway
Revere, MA 02151-3034

Mailing address

225B Fallon Rd
Stoneham, MA 02180-2903
Phone (857) 250-7611

Other identifiers 1

IdentifierTypeStateIssuer
RN2296332OtherMARN

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2296332MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1063931327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225B FALLON RD",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021802903",
            "telephone_number": "857-250-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 BROADWAY",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513034",
            "telephone_number": "781-485-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LEYANNA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2296332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "RN2296332",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Revere, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; 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.