Shawn P Williams, DC, PHD

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00635600 Issued in NJ

Practice address

211 Bellevue Ave
Suite 206
Montclair, NJ 07043-1820

Phone

(718) 702-8756

NPI assigned

May 31, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1245431774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 NEWELL DR",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033023",
            "telephone_number": "718-702-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 BELLEVUE AVE",
            "address_2": "SUITE 206",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431820",
            "telephone_number": "718-702-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHAWN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DC, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00635600",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0109831",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeri Isaacson Will, PHD
• Tracy Williams-Healy
• Nancy Lynn Williams, LCSW
• Odayne Williams
• Rebecca Williams, BEHAVIORAL ASSISTANT
• Terry Williams
• Arnold Wilson, PH.D.
• Kathryn Wilt, OTR/L
• Celeste R Winberry, LCSW
• Linda Winful, APN

• Chiropractor in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.