Kenyetta T Ellis-Williams

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R225384 Issued in MD

Practice address

4901 Spring Garden Dr Ste LL
Baltimore, MD 21209-4670

Phone

(410) 812-4253

Fax

(443) 249-9951

NPI assigned

Jun 19, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• New Beginnings II

  • Home Health Registered Nurse
  • Baltimore, MD
  • NPI 1689560914
  NPD Authorized official

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1104713403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 SPRING GARDEN DR STE LL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094670",
            "telephone_number": "410-812-4253",
            "fax_number": "443-249-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 SPRING GARDEN DR STE LL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094670",
            "telephone_number": "410-812-4253",
            "fax_number": "443-249-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS-WILLIAMS",
        "first_name": "KENYETTA",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R225384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stevan Hugh Elliott, D.C.
• Sydney Elliott
• Tlaya Elliott
• Valerie Ann Elliott, CRNP
• Amirah Ellis-Underwood
• Caitlyn Ellis, LMSW
• Jennifer Danielle Ellis, PH.D
• Jeremy Rasiah Ellis
• Jerrl Antwon Ellis
• Katherine Hill Ellis

• Registered Nurse in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.