Active NPI
Nicole Marie Williams, PA-C
- Medical Physician Assistant
- Belen, NM
National Provider Identifier
1346405180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA2008-0008
- Practice address
- 703 South Christopher Road
Belen, NM 87002 - Phone
- (505) 864-7781
- Fax
- (505) 864-3360
- NPI assigned
- Jul 22, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA2008-0008 | NM | Primary |
Addresses
Primary practice location
703 South Christopher Road
Belen, NM 87002
Mailing address
703 South Christopher Road
Belen, NM 87002
Phone (505) 864-7781
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2008-0008 | NM | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216684800000",
"number": "1346405180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 SOUTH CHRISTOPHER ROAD",
"city": "BELEN",
"state": "NM",
"postal_code": "87002",
"telephone_number": "505-864-7781",
"fax_number": "505-864-3360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 SOUTH CHRISTOPHER ROAD",
"city": "BELEN",
"state": "NM",
"postal_code": "87002",
"telephone_number": "505-864-7781",
"fax_number": "505-864-3360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "NICOLE",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-22",
"last_updated": "2008-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NM",
"license": "PA2008-0008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belen, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.