Active NPI
Jerone Williams
- Community Health Worker
- Muskegon, MI
National Provider Identifier
1093124091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 349 Jackson Ave
Breakthrough Believers
Muskegon, MI 49442-1114 - Phone
- (231) 343-2753
- NPI assigned
- Aug 5, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | MI | ||
| Contractor | 171W00000X | MI | ||
| Community Health Worker | 172V00000X | MI | Primary | |
| Health Educator | 174H00000X | MI |
Addresses
Primary practice location
349 Jackson Ave
Breakthrough Believers
Muskegon, MI 49442-1114
Mailing address
349 Jackson Ave
Breakthrough Believers
Muskegon, MI 49442-1114
Phone (231) 343-2753
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376866160 | Medicaid | MI |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Breakthrough Believers Recovery and Healing Center | Case Manager/Care Coordinator | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Magnolia, TX
- NPI 1376866160
Case Manager/Care Coordinator
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407196800000",
"number": "1093124091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "349 JACKSON AVE",
"address_2": "BREAKTHROUGH BELIEVERS",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494421114",
"telephone_number": "231-343-2753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "349 JACKSON AVE",
"address_2": "BREAKTHROUGH BELIEVERS",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494421114",
"telephone_number": "231-343-2753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JERONE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-08-05",
"last_updated": "2014-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "MI",
"license": null,
"primary": true
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "MI",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1376866160",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.