Active NPI
Charles Williams
- Driver
- Shreveport, LA
National Provider Identifier
1104285287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 2380885
- Practice address
- 1535 River Parkway Blvd
#1108
Shreveport, LA 71104-1808 - Phone
- (318) 828-1500
- Fax
- (318) 670-6736
- NPI assigned
- Feb 17, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 2380885 | LA | Primary |
Addresses
Primary practice location
1535 River Parkway Blvd
#1108
Shreveport, LA 71104-1808
Mailing address
1535 River Parkway Blvd
#1108
Shreveport, LA 71104-1808
Phone (318) 828-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2380885 | Medicaid | LA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2380885 | LA | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meditrips LLC | Current | Accepting new patients | |
| Northwest Regional Transportation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Non-emergency Medical Transport (VAN)
- Shreveport, LA
- NPI 1861866907
-
- Non-emergency Medical Transport (VAN)
- Shreveport, LA
- NPI 1063003820
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455667200000",
"number": "1104285287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1535 RIVER PARKWAY BLVD",
"address_2": "#1108",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711041808",
"telephone_number": "318-828-1500",
"fax_number": "318-670-6736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1535 RIVER PARKWAY BLVD",
"address_2": "#1108",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711041808",
"telephone_number": "318-828-1500",
"fax_number": "318-670-6736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "CHARLES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-17",
"last_updated": "2016-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "LA",
"license": "2380885",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2380885",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.