Individual provider Active NPI

Michael Robert Williams Jr.

  • Homemaker
  • Charlotte, NC
National Provider Identifier
1104781517
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
License
D08723554 Issued in AZ
Practice address
6406 Rockshire Dr
Charlotte, NC 28227-8028
Phone
(248) 707-0580
NPI assigned
Dec 17, 2025
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X D08723554 AZ
Homemaker 376J00000X D08723554 AZ Primary
Driver 172A00000X D08723554 AZ

Addresses

Primary practice location

6406 Rockshire Dr
Charlotte, NC 28227-8028

Mailing address

6406 Rockshire Dr
Charlotte, NC 28227-8028
Phone (248) 707-0580

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

LicenseStateTypeSpecialty
D08723554AZMDHomemaker

NPI Registry JSON

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

{
    "created_epoch": "1765929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1104781517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 ROCKSHIRE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282278028",
            "telephone_number": "248-707-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6406 ROCKSHIRE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282278028",
            "telephone_number": "248-707-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-17",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "AZ",
            "license": "D08723554",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "AZ",
            "license": "D08723554",
            "primary": true
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "AZ",
            "license": "D08723554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.