Individual provider Active NPI

Mary Amanda Williams, RN

  • School Registered Nurse
  • Columbia, SC
National Provider Identifier
1285005702
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
215736 Issued in SC
Practice address
6706 Nursery Rd
Columbia, SC 29212-2020
Phone
(803) 476-4300
NPI assigned
Oct 9, 2015
Last updated
Oct 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 215736 SC Primary

Addresses

Primary practice location

6706 Nursery Rd
Columbia, SC 29212-2020

Mailing address

6706 Nursery Rd
Columbia, SC 29212-2020
Phone (803) 476-4300

Other identifiers 1

IdentifierTypeStateIssuer
215736MedicaidSC

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
215736SCMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1285005702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6706 NURSERY RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292122020",
            "telephone_number": "803-476-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6706 NURSERY RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292122020",
            "telephone_number": "803-476-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARY",
        "middle_name": "AMANDA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "SC",
            "license": "215736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215736",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.