Dominique Lillian McCray Williams, LAT, ATC, EMT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

LAT-3877 Issued in NC

Practice address

11221 Galleria Ave
Raleigh, NC 27614-8137

Phone

(919) 562-9410

Fax

(919) 562-9425

NPI assigned

May 29, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dominique Lillian McCray Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Emergency Medical Technician

State licenses

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1245721968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 CAMPANA DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276039492",
            "telephone_number": "919-325-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11221 GALLERIA AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148137",
            "telephone_number": "919-562-9410",
            "fax_number": "919-562-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DOMINIQUE",
        "middle_name": "LILLIAN MCCRAY",
        "credential": "LAT, ATC, EMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NC",
            "license": "P092137",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "2000031606",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-3877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMINIQUE",
            "last_name": "MCCRAY",
            "middle_name": "LILLIAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Emerson Williams
• Deborah Williams, RN
• Destiny Williams
• Diamond Williams, RBT
• Dominique Williams
• Doren Williams
• Dustin Williams, ARNP FNP
• Edward A Williams, LCSW
• Elizabeth Surovec Williams, PA-C
• Erica Williams

• Athletic Trainer in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.

Verify at the official NPI Registry.