Active NPI
Priscilla Williams
- Licensed Practical Nurse
- Lithia, FL
National Provider Identifier
1336769249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN5150970
- Practice address
- 5822 Tanagerlake Rd
Lithia, FL 33547-5871 - Phone
- (727) 421-5521
- NPI assigned
- Apr 21, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN5150970 | FL | Primary |
Addresses
Primary practice location
5822 Tanagerlake Rd
Lithia, FL 33547-5871
Mailing address
5822 Tanagerlake Rd
Lithia, FL 33547-5871
Phone (727) 421-5521
Other practice location 1
5822 Tanagerlake Rd
Lithia, FL 33547-5871
Phone (727) 421-5521 ext. 72742
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PN5150970 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | 7274215521 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN5150970 | FL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587427200000",
"number": "1336769249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5822 TANAGERLAKE RD",
"city": "LITHIA",
"state": "FL",
"postal_code": "335475871",
"telephone_number": "727-421-5521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5822 TANAGERLAKE RD",
"city": "LITHIA",
"state": "FL",
"postal_code": "335475871",
"telephone_number": "727-421-5521"
}
],
"practiceLocations": [
{
"address_1": "5822 Tanagerlake Rd",
"address_purpose": "LOCATION",
"city": "Lithia",
"state": "FL",
"postal_code": "335475871",
"country_code": "US",
"telephone_number": "727-421-5521 x72742",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "PRISCILLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-21",
"last_updated": "2020-04-21",
"certification_date": "2020-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "PN5150970",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PN5150970",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "7274215521",
"affiliation": "N",
"endpointDescription": "phone",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "5822 Tanagerlake Rd",
"city": "Lithia",
"state": "FL",
"country_code": "US",
"postal_code": "335475871",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lithia, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.