Active NPI
Latarsha Williams
- Customized Equipment (DME)
- Dorchester, MA
National Provider Identifier
1154837227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- License
- 58895
- Practice address
- 84 Welles Ave
Dorchester, MA 02124-2444 - Phone
- (617) 436-8400
- NPI assigned
- Dec 27, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | 58895 | MA | |
| Customized Equipment (DME) | 332BC3200X | 58895 | MA | Primary |
Addresses
Primary practice location
84 Welles Ave
Dorchester, MA 02124-2444
Mailing address
337 Adams St
Dorchester, MA 02122-1232
Phone (617) 436-8400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58895 | Other | MA | MA STATE COCOSMETOLOGY LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 58895 | MA | MD | Parenteral & Enteral Nutrition Supplies (DME) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1154837227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "337 ADAMS ST",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021221232",
"telephone_number": "617-436-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 WELLES AVE",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021242444",
"telephone_number": "617-436-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "LATARSHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-27",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": "MA",
"license": "58895",
"primary": false
},
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": "MA",
"license": "58895",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA STATE COCOSMETOLOGY LICENSE NUMBER",
"identifier": "58895",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.