Individual provider Active NPI

Marcellus A Williams

  • Physical Therapy Assistant
  • Fredericksburg, VA
National Provider Identifier
1134089840
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306606833 Issued in VA
Practice address
3310 Fall Hill Ave
Fredericksburg, VA 22401-3000
Phone
(540) 373-7133
Fax
(540) 373-7133
NPI assigned
Nov 14, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306606833 VA Primary

Addresses

Primary practice location

3310 Fall Hill Ave
Fredericksburg, VA 22401-3000

Mailing address

12621 Plantation Dr
Spotsylvania, VA 22551-8037
Phone (540) 842-9756

Other practice location 1

9530 Cosner Dr Ste 100
Fredericksburg, VA 22408-7760
Phone (540) 735-0401

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
2306606833VAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1763078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1134089840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12621 PLANTATION DR",
            "city": "SPOTSYLVANIA",
            "state": "VA",
            "postal_code": "225518037",
            "telephone_number": "540-842-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 FALL HILL AVE",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013000",
            "telephone_number": "540-373-7133",
            "fax_number": "540-373-7133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9530 Cosner Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224087760",
            "country_code": "US",
            "telephone_number": "540-735-0401",
            "fax_number": "540-735-0401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARCELLUS",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-14",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306606833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.