Individual provider Active NPI

Andray McWilliams

  • Driver
  • Atlanta, GA
National Provider Identifier
1346668969
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
592289560 Issued in FL
Practice address
4060 Peachtree Rd NE Ste D145
Atlanta, GA 30319-3020
Phone
(561) 449-3716
NPI assigned
Apr 1, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 592389561 FL
Driver 172A00000X 592289560 FL Primary

Addresses

Primary practice location

4060 Peachtree Rd NE Ste D145
Atlanta, GA 30319-3020

Mailing address

4060 Peachtree Rd NE Ste D145
Atlanta, GA 30319-3020
Phone (561) 449-3716

Other identifiers 1

IdentifierTypeStateIssuer
592389569AMedicaidFL

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

LicenseStateTypeSpecialty
592389561FLMDCase Manager/Care Coordinator
592289560FLMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1346668969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 PEACHTREE RD NE STE D145",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303193020",
            "telephone_number": "561-449-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 PEACHTREE RD NE STE D145",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303193020",
            "telephone_number": "561-449-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWILLIAMS",
        "first_name": "ANDRAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "592389561",
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "FL",
            "license": "592289560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "592389569A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.