Dominic Desean Williams, RKT

Primary specialty

KinesiotherapistTaxonomy code 226300000X

Practice address

619 S Marion Ave
Lake City, FL 32025-5808

Phone

(386) 755-3016

NPI assigned

Apr 22, 2022

Sex

Male

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

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1114661568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 SW AMBERWOOD LOOP # 810-105",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "386-755-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DOMINIC",
        "middle_name": "DESEAN",
        "credential": "RKT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justina Wilkerson
• Myeisha Williams-Jackson
• Carmen C Williams, RN
• Chantel Williams
• Derek Williams, LPN
• Jameelah N Williams
• Jason Wayne Williams, RN,MSN, TCRN, FNP-BC
• Jennifer Williams
• Karyne Williams
• Katherine Denese Williams, APRN

• Kinesiotherapist in Lake City, FL
• Providers in Lake City, FL by specialty
• Kinesiotherapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.