Active NPI
Rose Thigpen Williams, M.A., LPA #1646
- Psychologist
- Beulaville, NC
National Provider Identifier
1285762930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LPA 1646
- Practice address
- 219 East Main Street
Beulaville, NC 28518-0786 - Phone
- (910) 298-4994
- Fax
- (910) 298-6320
- NPI assigned
- Mar 2, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | LPA 1646 | NC | Primary |
Addresses
Primary practice location
219 East Main Street
Beulaville, NC 28518-0786
Mailing address
PO Box 786
219 East Main Street
Beulaville, NC 28518-0786
Phone (910) 298-4994
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6107132 | Medicaid | NC | |
| 1389X | Other | NC | BLUE CROSS BLUE SHIEL |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPA 1646 | NC | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285762930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 786",
"address_2": "219 EAST MAIN STREET",
"city": "BEULAVILLE",
"state": "NC",
"postal_code": "285180786",
"telephone_number": "910-298-4994",
"fax_number": "910-298-6320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 EAST MAIN STREET",
"city": "BEULAVILLE",
"state": "NC",
"postal_code": "285180786",
"telephone_number": "910-298-4994",
"fax_number": "910-298-6320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "ROSE",
"middle_name": "THIGPEN",
"credential": "M.A., LPA #1646",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "LPA 1646",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6107132",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIEL",
"identifier": "1389X",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beulaville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.