Individual provider Active NPI

Shaquela C Williams

  • Community Health Worker
  • Cleveland, OH
National Provider Identifier
1255173225
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
1008 E 152ND St Ste B
Cleveland, OH 44110-3300
Phone
(330) 418-8351
NPI assigned
Jun 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

1008 E 152ND St Ste B
Cleveland, OH 44110-3300

Mailing address

944 E 147TH St Apt 3
Cleveland, OH 44110-3732
Phone (330) 705-1937

Other practice location 1

2490 Lee Blvd Ste B306
Cleveland Heights, OH 44118-1268
Phone (330) 418-8351

Other practice location 2

944 E 147th St Apt 3
Cleveland, OH 44110-3732
Phone (330) 705-1937

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fun-to-the-Mental Community Health Worker CurrentSince Jul 21, 2024 Accepting new patients

Locations

1008 E 152nd St
Ste B
Cleveland, OH 44110
Phone (330) 418-8351

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1255173225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 E 147TH ST APT 3",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441103732",
            "telephone_number": "330-705-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 E 152ND ST STE B",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441103300",
            "telephone_number": "330-418-8351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2490 Lee Blvd Ste B306",
            "address_purpose": "LOCATION",
            "city": "Cleveland Heights",
            "state": "OH",
            "postal_code": "441181268",
            "country_code": "US",
            "telephone_number": "330-418-8351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "944 E 147th St Apt 3",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441103732",
            "country_code": "US",
            "telephone_number": "330-705-1937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHAQUELA",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.