Individual provider Active NPI

Keturah Danyelle Williams

  • Certified Registered Nurse Anesthetist
  • Raleigh, NC
National Provider Identifier
1104594845
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
7599 Issued in NC
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone
(919) 350-8000
NPI assigned
Aug 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 286105 NC
Certified Registered Nurse Anesthetist 367500000X 7599 NC Primary

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1231

Mailing address

9129 Falkwood Rd
Raleigh, NC 27617-8210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241204001058 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052847894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Duke University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

1001 W Williams St
Suite 103
Apex, NC 27502-3978
Phone (919) 439-7867

Hospital & facility affiliations

  • Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
286105NCMDRegistered Nurse
7599NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Anesthesia Associates, PLLC Registered Nurse CurrentSince Dec 15, 2024 Accepting new patients

Locations

1001 W Williams St
Ste 103
Apex, NC 27502
Phone (919) 363-2111

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1104594845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9129 FALKWOOD RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276178210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-350-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KETURAH",
        "middle_name": "DANYELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "286105",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "7599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.