Modupe O Williams, NP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2319054 Issued in MA

Practice address

1 Kristen Dr
North Providence, RI 02911-2932

Phone

(401) 447-8569

NPI assigned

Oct 23, 2017

Last updated

Oct 23, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Agape Homes of Rhode Island LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Johnston, RI
  • NPI 1669102463
  NPD Authorized official
• Modupe

  • Nursing Facility/Intermediate Care Facility
  • North Providence, RI
  • NPI 1235676289
  NPD (past) Authorized official

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1265943724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KRISTEN DR",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029112932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KRISTEN DR",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029112932",
            "telephone_number": "401-447-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MODUPE",
        "middle_name": "O",
        "credential": "NP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2319054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12345676289",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12345676289",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Webster, PA-C
• Lauren Weil, DPT, OCS
• Wellness Resolutions, LLC
• Wellnorth Medical LLC
• Alison Whitty
• Morgan Elizabeth Wilson
• Alexandra Lynn Winnes, PT, DPT
• Margot Carolyn Wolf, PHARMD
• X
• Jean Yeomans

• Family Nurse Practitioner in North Providence, RI
• Providers in North Providence, RI by specialty
• Family Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.