Active NPI
Brandy Shannon Williams, PA-C
- Physician Assistant
- Barksdale AFB, LA
National Provider Identifier
1134633654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 243 Curtiss Rd Ste 100
Barksdale AFB, LA 71110-2425 - Phone
- (318) 456-6555
- NPI assigned
- Nov 20, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
243 Curtiss Rd Ste 100
Barksdale AFB, LA 71110-2425
Mailing address
243 Curtiss Rd Ste 100
Barksdale AFB, LA 71110-2425
Phone (318) 456-6555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210409001161 | AR | Order and Referring Only - Physician Assistant | 2961810007 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695772800000",
"number": "1134633654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "243 CURTISS RD STE 100",
"city": "BARKSDALE AFB",
"state": "LA",
"postal_code": "711102425",
"telephone_number": "318-456-6555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243 CURTISS RD STE 100",
"city": "BARKSDALE AFB",
"state": "LA",
"postal_code": "711102425",
"telephone_number": "318-456-6555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "BRANDY",
"middle_name": "SHANNON",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-20",
"last_updated": "2023-09-27",
"certification_date": "2023-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barksdale AFB, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.