Individual provider Active NPI

David Stuart Williams

  • Student in an Organized Health Care Education/Training Program
  • Tyler, TX
National Provider Identifier
1316252984
Registry record updated Aug 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1401 Woodland Hills Dr
Tyler, TX 75701-8527
Phone
(903) 521-2221
NPI assigned
Aug 8, 2010
Last updated
Aug 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Paramedic 146L00000X 12218 TX
Emergency Registered Nurse 163WE0003X 694863 TX
Pharmacy Technician 183700000X 5001-0701-0049-881
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1401 Woodland Hills Dr
Tyler, TX 75701-8527

Mailing address

PO Box 9693
Tyler, TX 75711-2693
Phone (903) 521-2221

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

LicenseStateTypeSpecialty
12218TXMDAddiction (Substance Use Disorder) Counselor
694863TXMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1281225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281225600000",
    "number": "1316252984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9693",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757112693",
            "telephone_number": "903-521-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 WOODLAND HILLS DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018527",
            "telephone_number": "903-521-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DAVID",
        "middle_name": "STUART",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-08",
        "last_updated": "2010-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "TX",
            "license": "12218",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TX",
            "license": "694863",
            "primary": false
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": null,
            "license": "5001-0701-0049-881",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2010; 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.