Active NPI
Mary Deanna Williams
- Home Health Agency
- Lorain, OH
National Provider Identifier
1265996839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 402064640518
- Practice address
- 210 W 18TH St
Lorain, OH 44052-3712 - Phone
- (440) 984-9818
- NPI assigned
- Jan 28, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 402064640518 | OH | Primary |
Addresses
Primary practice location
210 W 18TH St
Lorain, OH 44052-3712
Mailing address
210 W 18TH St
Lorain, OH 44052-3712
Phone (440) 984-9818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0324841 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 402064640518 | OH | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548633600000",
"number": "1265996839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 W 18TH ST",
"city": "LORAIN",
"state": "OH",
"postal_code": "440523712",
"telephone_number": "440-984-9818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 W 18TH ST",
"city": "LORAIN",
"state": "OH",
"postal_code": "440523712",
"telephone_number": "440-984-9818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MARY",
"middle_name": "DEANNA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-28",
"last_updated": "2019-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "OH",
"license": "402064640518",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0324841",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.