Individual provider Active NPI

Ivory Denzel Williams

  • Case Manager/Care Coordinator
  • Meridian, ID
National Provider Identifier
1336073691
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
KB158044B Issued in ID
Practice address
324 NE 3Rd St Apt B201
Meridian, ID 83642-2768
Phone
(208) 791-6599
NPI assigned
Jun 11, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X SINGLE SPECIALTY GROUP 171M00000X KB158044B ID Primary

Addresses

Primary practice location

324 NE 3Rd St Apt B201
Meridian, ID 83642-2768

Mailing address

324 NE 3Rd St Apt B201
Meridian, ID 83642-2768
Phone (208) 791-6599

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

NPI Registry JSON

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

{
    "created_epoch": "1781136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1336073691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 NE 3RD ST APT B201",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422768",
            "telephone_number": "208-791-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 NE 3RD ST APT B201",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422768",
            "telephone_number": "208-791-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "IVORY",
        "middle_name": "DENZEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-11",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "ID",
            "license": "KB158044B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.