Individual provider Active NPI

Kimadie Williams

  • Licensed Practical Nurse
  • Reynoldsburg, OH
National Provider Identifier
1326459488
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.141133-M-IV Issued in OH
Practice address
3095 Deepwood Dr
Reynoldsburg, OH 43068-4053
Phone
(614) 607-9741
NPI assigned
May 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.141133-M-IV OH Primary

Addresses

Primary practice location

3095 Deepwood Dr
Reynoldsburg, OH 43068-4053

Mailing address

3095 Deepwood Dr
Reynoldsburg, OH 43068-4053
Phone (614) 607-9741

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
PN.141133-M-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1326459488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 DEEPWOOD DR",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430684053",
            "telephone_number": "614-607-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 DEEPWOOD DR",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430684053",
            "telephone_number": "614-607-9741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KIMADIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.141133-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.