Individual provider Active NPI

Juanita Williams

  • Case Manager/Care Coordinator
  • Elizabethtown, KY
National Provider Identifier
1205307766
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
723 Hawkins Dr
Elizabethtown, KY 42701-1063
Phone
(270) 900-0373
Fax
(270) 900-0426
NPI assigned
Dec 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

723 Hawkins Dr
Elizabethtown, KY 42701-1063

Mailing address

PO Box 1086
Elizabethtown, KY 42702-1086
Phone (270) 900-0373

Other practice location 1

725 New Glendale Rd
Elizabethtown, KY 42701-8373
Phone (270) 900-0373

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": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1205307766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1086",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427021086",
            "telephone_number": "270-900-0373",
            "fax_number": "270-900-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 HAWKINS DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011063",
            "telephone_number": "270-900-0373",
            "fax_number": "270-900-0426"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 New Glendale Rd",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427018373",
            "country_code": "US",
            "telephone_number": "270-900-0373",
            "fax_number": "270-900-0426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JUANITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.

Verify at the official NPI Registry.