Individual provider Active NPI

Patricia C Williams, BSN RN ACRN

  • Administrator Registered Nurse
  • Jamaica, NY
National Provider Identifier
1174708697
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
399792-1 Issued in NY
Practice address
10504 Sutphin Blvd
Jamaica, NY 11435-5022
Phone
(718) 725-5000
Fax
(718) 725-5080
NPI assigned
Jan 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 399792-1 NY Primary

Addresses

Primary practice location

10504 Sutphin Blvd
Jamaica, NY 11435-5022

Mailing address

10504 Sutphin Blvd
Jamaica, NY 11435-5022
Phone (718) 725-5000

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
399792-1NYMDAdministrator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199318400000",
    "number": "1174708697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10504 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114355022",
            "telephone_number": "718-725-5000",
            "fax_number": "718-725-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10504 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114355022",
            "telephone_number": "718-725-5000",
            "fax_number": "718-725-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PATRICIA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "BSN RN ACRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NY",
            "license": "399792-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.