Andrea Williams, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007402 Issued in MI

Practice address

22837 Avalon St
Saint Clair Shores, MI 48080-2468

Phone

(586) 899-1950

NPI assigned

Nov 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• American Current Care of Michigan PC

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Grand Rapids, MI
  • NPI 1659562262
  Medicare reassignment
• American Current Care of Michigan PC

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Warren, MI
  • NPI 1477745495
  NPD

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1083915052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26185 GREENFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480764709",
            "telephone_number": "586-899-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22837 AVALON ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802468",
            "telephone_number": "586-899-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANDREA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105695",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "DZ831Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00878021",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002913600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Beaumont Hospital
• William C Irving PHD PLLC
• William L. Bristol, M.D.,P.C.
• Yvonne Williams-Houilles, MSW
• Acacia Williams
• Jeffrey L Williams, MD
• Patrice Williams, COTA/L
• Braniyla Willis
• Jeanette Elizabeth Wilson, M.D.
• Stephen Wilson, MD

• Physician Assistant in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.