Cornelius Williams

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MHL-091-110 Issued in NC

Practice address

121 Young St
Henderson, NC 27536-4248

Phone

(252) 598-1008

NPI assigned

Mar 14, 2019

Sex

Male

Sole proprietor

Yes

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

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.

• Guardian Angel Healthcare, LLC

  • Community/Behavioral Health Agency
  • Creedmoor, NC
  • NPI 1174082036
  NPD (past) Authorized official

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1124587720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2002",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362002",
            "telephone_number": "252-204-1381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 YOUNG ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364248",
            "telephone_number": "252-598-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CORNELIUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-091-110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Williams Wellcare & Protective Pathways, PLLC
• Angula Terrell Williams
• Brittany Williams, SSP
• Cayla Symone Williams
• Christopher Terrill Williams
• James Williams, RPH
• Nekisha Williams
• Pamela Elaine Williams, M.S.
• Shukana Liquori Williams
• Shurondia C Williams, BS, MSW, LCSW-A

• Community/Behavioral Health Agency in Henderson, NC
• Providers in Henderson, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; 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.