Individual provider Active NPI

Amy Ruth Williams

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, OR
National Provider Identifier
1336646223
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0030217 Issued in OH
Practice address
147 Commercial St NE Ste 17
Salem, OR 97301-3418
Phone
(470) 415-1502
Fax
(470) 415-1502
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 0030217 OH Primary
Primary Care Nurse Practitioner 363LP2300X RN244037 GA
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 10041502 OR

Addresses

Primary practice location

147 Commercial St NE Ste 17
Salem, OR 97301-3418

Mailing address

147 Commercial St NE Ste 17
Salem, OR 97301-3418
Phone (470) 415-1502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222003650 OH Practitioner - Nurse Practitioner 6709220239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0030217OHMDPsychiatric/Mental Health Nurse Practitioner
RN244037GAMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1336646223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 COMMERCIAL ST NE STE 17",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013418",
            "telephone_number": "470-415-1502",
            "fax_number": "971-238-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 COMMERCIAL ST NE STE 17",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013418",
            "telephone_number": "470-415-1502",
            "fax_number": "470-415-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AMY",
        "middle_name": "RUTH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0030217",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN244037",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10041502",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.