Individual provider Active NPI

Marie A Williams, NP

  • Nurse Practitioner
  • Carbondale, PA
National Provider Identifier
1093706780
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
320060-1 Issued in NY
Practice address
30-32 N Main St
Carbondale, PA 18407-2304
Phone
(570) 282-1732
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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 320060-1 NY Primary

Addresses

Primary practice location

30-32 N Main St
Carbondale, PA 18407-2304

Mailing address

30-32 N Main St
Carbondale, PA 18407-2304
Phone (570) 282-1732

Other identifiers 1

IdentifierTypeStateIssuer
02707257MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150122000668 PA Practitioner - Nurse Practitioner 3476588807 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
320060-1NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Merakey Pennsylvania Current Accepting new patients
Merakey Pennsylvania CurrentSince Nov 12, 2014 Accepting new patients
B-K Health Center, Inc CurrentSince Oct 1, 2018 Accepting new patients
B-K Health Center, Inc CurrentSince Oct 1, 2018 Accepting new patients
Merakey Pennsylvania CurrentSince Nov 12, 2014 Accepting new patients
United Health Services Hospitals, Inc. PastSince Jan 1, 2010 Accepting new patients

Locations

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

30-32 N Main St
Carbondale, PA 18407
Phone (570) 282-1732

127 Route 106
Greenfield Township, PA 18407
Phone 57027875001012

25066 State Route 11
Hallstead, PA 18822
Phone (570) 879-5249

4391 Sturbridge Dr
Harrisburg, PA 17110
Phone (717) 441-9457

840 Main St
Honesdale, PA 18431
Phone (570) 253-0321

620 Germantown Pike
Lafayette Hl, PA 19444
Phone (313) 278-2327

498 S Main St
Ste D
Montrose, PA 18801
Phone (570) 278-7500

1151 Pocono Blvd
Mount Pocono, PA 18344
Phone (570) 243-8787

2380 Elk Lake School Rd
Springville, PA 18844
Phone (570) 278-1106

Interoperability endpoints

  • Direct secure messaging: mwilliams@nepachc.medentdirect.com

Organizations & group practices 6

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1093706780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30-32 N MAIN ST",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184072304",
            "telephone_number": "570-282-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30-32 N MAIN ST",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184072304",
            "telephone_number": "570-282-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARIE",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "320060-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02707257",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, PA

Sources for this page

Verify at the official NPI Registry.