Jessica Danielle Williams, RN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

0000250279 Issued in TN

Practice address

332 Sumner Hall Dr
Gallatin, TN 37066-3129

Phone

(615) 460-4500

NPI assigned

May 14, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1184298085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 SUMNER HALL DR",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 SUMNER HALL DR",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663129",
            "telephone_number": "615-460-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JESSICA",
        "middle_name": "DANIELLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "TN",
            "license": "0000250279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Work",
            "affiliation": "N",
            "address_1": "332 Sumner Hall Dr",
            "city": "Gallatin",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370663129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wild Bloom Chiropractic LLC
• Ann Elizabeth Willert, M.ED, NCC
• Alyssa Williams, M.S. CCC-SLP
• Caitlin Samantha Williams, BCBA, LBA
• Hannah Williams, BCBA
• Pamela Williams, SLP-CCC
• Shante Williams
• Jessica Ann Williamson, OTR
• Ashley Willis, SLP-CCC
• Ralyn McClay Willis, PA-C

• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Gallatin, TN
• Providers in Gallatin, TN by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.