Active NPI
Joanetta Marie Williams, COSMETOLOGIST
- Prosthetist
- Hattiesburg, MS
National Provider Identifier
1295203602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- License
- 00-12147
- Practice address
- 806 S 28TH Ave
Hattiesburg, MS 39402-2601 - Phone
- (601) 606-7652
- NPI assigned
- Nov 5, 2018
- 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 |
|---|---|---|---|---|
| Prosthetist | 224P00000X | 00-12147 | MS | Primary |
Addresses
Primary practice location
806 S 28TH Ave
Hattiesburg, MS 39402-2601
Mailing address
PO Box 18956
Hattiesburg, MS 39404-8956
Phone (662) 967-1741
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 |
|---|---|---|---|
| 00-12147 | MS | MD | Prosthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541376000000",
"number": "1295203602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18956",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394048956",
"telephone_number": "662-967-1741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "806 S 28TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394022601",
"telephone_number": "601-606-7652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JOANETTA",
"middle_name": "MARIE",
"credential": "COSMETOLOGIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-05",
"last_updated": "2018-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "MS",
"license": "00-12147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.