Jacqueline Kay Williams, RD, LD

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

00979 Issued in TX

Practice address

15008 Sendero LN
Waco, TX 76712-7570

Phone

(254) 776-7342

NPI assigned

Jan 19, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 20, 2022 through Sep 20, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Compleo Physical Therapy & Wellness LLC

  • Physical Therapist
  • Woodway, TX
  • NPI 1902338395

  Nutrition, Metabolic

  NPD (past)

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1346758745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15008 SENDERO LN",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127570",
            "telephone_number": "254-776-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15008 SENDERO LN",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127570",
            "telephone_number": "254-776-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACQUELINE",
        "middle_name": "KAY",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "TX",
            "license": "00979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William a. Peper, M.D., P.a.
• Amy Moes Williams, PH.D.
• Austin Ross Williams
• Cody Z Williams, PA-C
• J Gary Williams, DDS
• Jashadreale Williams, BT
• Jeanne Williams, LPC
• Jona M Williams, COTA
• Linda A Williams, MD
• Matthea Sherrell Williams, LAT, ATC

• Metabolic Nutrition Registered Dietitian in Waco, TX
• Providers in Waco, TX by specialty
• Metabolic Nutrition Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.