Active NPI
Misty Dawn Williams
- Personal Care Attendant
- Enterprise, WV
National Provider Identifier
1194400812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 151 Bridgewater Dr
Enterprise, WV 26568-7245 - Phone
- (304) 612-7877
- NPI assigned
- Jun 20, 2023
- 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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary |
Addresses
Primary practice location
151 Bridgewater Dr
Enterprise, WV 26568-7245
Mailing address
151 Bridgewater Dr
Enterprise, WV 26568-7245
Phone (304) 612-7877
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687219200000",
"number": "1194400812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 BRIDGEWATER DR",
"city": "ENTERPRISE",
"state": "WV",
"postal_code": "265687245",
"telephone_number": "304-612-7877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 BRIDGEWATER DR",
"city": "ENTERPRISE",
"state": "WV",
"postal_code": "265687245",
"telephone_number": "304-612-7877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MISTY",
"middle_name": "DAWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-20",
"last_updated": "2023-06-20",
"certification_date": "2023-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enterprise, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.