NPIMap

Individual provider Active NPI

Darryll Andre' Williams, D.C.

  • Chiropractor
  • Winston Salem, NC
National Provider Identifier
1346577848
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4305 Issued in NC
Practice address
3000 Maplewood Ave
Suite 102
Winston Salem, NC 27103-4002
Phone
(336) 829-5235
NPI assigned
Nov 4, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4305 NC Primary

Addresses

Primary practice location

3000 Maplewood Ave
Suite 102
Winston Salem, NC 27103-4002

Mailing address

3000 Maplewood Ave
Suite 102
Winston Salem, NC 27103-4002
Phone (336) 829-5235

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

LicenseStateTypeSpecialty
4305NCMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Health Carolinas, PLLC PastSince May 5, 2021 Accepting new patients
Southeast Sports Chiropractic, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1346577848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MAPLEWOOD AVE",
            "address_2": "SUITE 102",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034002",
            "telephone_number": "336-829-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MAPLEWOOD AVE",
            "address_2": "SUITE 102",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034002",
            "telephone_number": "336-829-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DARRYLL",
        "middle_name": "ANDRE'",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-04",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.