Active NPI
Joane Camille Williams, M.A.,CCC-SLP
- Nursing Facility/Intermediate Care Facility
- South Bend, IN
National Provider Identifier
1134403033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 22003267A
- Practice address
- 1950 Ridgedale Rd
South Bend, IN 46614-2243 - Phone
- (574) 707-3970
- NPI assigned
- Oct 11, 2011
- Last updated
- Oct 11, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 22003267A | IN | Primary |
Addresses
Primary practice location
1950 Ridgedale Rd
South Bend, IN 46614-2243
Mailing address
1950 Ridgedale Rd
South Bend, IN 46614-2243
Phone (574) 707-3970
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22003267A | IN | MD | Nursing Facility/Intermediate Care Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318291200000",
"number": "1134403033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 RIDGEDALE RD",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466142243",
"telephone_number": "574-707-3970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 RIDGEDALE RD",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466142243",
"telephone_number": "574-707-3970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JOANE",
"middle_name": "CAMILLE",
"name_prefix": "Mrs.",
"credential": "M.A.,CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-11",
"last_updated": "2011-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "IN",
"license": "22003267A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.