Individual provider Active NPI

Jennifer Arbiso-Williams, RN

  • General Practice Registered Nurse
  • Philadelphia, PA
National Provider Identifier
1295443091
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
951875 Issued in CA
Practice address
1200 Intrepid Ave
Philadelphia, PA 19112-1229
Phone
(442) 370-1580
Fax
(442) 370-1580
NPI assigned
Nov 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 951875 CA Primary

Addresses

Primary practice location

1200 Intrepid Ave
Philadelphia, PA 19112-1229

Mailing address

58328 Bonanza Dr
Yucca Valley, CA 92284-6209
Phone (442) 370-1580

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL riteaid.com Direct

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
951875CAMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1295443091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58328 BONANZA DR",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922846209",
            "telephone_number": "442-370-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 INTREPID AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191121229",
            "telephone_number": "442-370-1580",
            "fax_number": "442-370-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARBISO-WILLIAMS",
        "first_name": "JENNIFER",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "951875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "riteaid.com",
            "affiliation": "N",
            "endpointDescription": "company website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "contact info to provider",
            "address_1": "1200 Intrepid Ave",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191121229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.