Andrea Williams, RN, APRN

Key facts

NPI

1265803530

Entity type

Individual (NPI type 1)

Primary specialty

Administrator Registered Nurse 163WA2000X

License

51082 (SC)

Practice address

500 Congaree Church Rd
Gadsden, SC 29052-9713

Phone

(803) 529-6351

NPI assigned

Oct 13, 2015

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 3, 2016.

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1265803530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CONGAREE CHURCH RD",
            "city": "GADSDEN",
            "state": "SC",
            "postal_code": "290529713",
            "telephone_number": "803-529-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CONGAREE CHURCH RD",
            "city": "GADSDEN",
            "state": "SC",
            "postal_code": "290529713",
            "telephone_number": "803-529-6351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANDREA",
        "credential": "RN, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "SC",
            "license": "51082",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "20286",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nichole Williams

All providers in Gadsden, SC · Administrator Registered Nurse in South Carolina