Individual provider Active NPI

Jennifer Joann-Olson Williams, PT, DPT

  • Physical Therapist
  • Clayton, NC
National Provider Identifier
1366520983
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8138 Issued in NC
Practice address
400 Guy Rd
Clayton, NC 27520-7205
Phone
(919) 553-8185
Fax
(919) 553-0187
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8138 NC Primary

Addresses

Primary practice location

400 Guy Rd
Clayton, NC 27520-7205

Mailing address

400 Guy Rd
Clayton, NC 27520-7205
Phone (919) 553-8185

Other identifiers 1

IdentifierTypeStateIssuer
7211430MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110110000337 NC Practitioner - Physical Therapist in Private Practice 2466641246 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

2147 Davie Ave
Statesville, NC 28625-9200
Phone (704) 994-5065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8138NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Sep 29, 2024 Accepting new patients
Mobile Rehab L.L.C. Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Sep 29, 2024 Accepting new patients
Orthos Physical Therapy Inc. Physical Therapist CurrentSince Jun 20, 2000 Accepting new patients

Locations

400 Guy Rd
Clayton, NC 27520
Phone (919) 553-8185

2147 Davie Ave
Statesville, NC 28625
Phone (704) 878-0123

Organizations & group practices 4

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1366520983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GUY RD",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275207205",
            "telephone_number": "919-553-8185",
            "fax_number": "919-553-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GUY RD",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275207205",
            "telephone_number": "919-553-8185",
            "fax_number": "919-553-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "middle_name": "JOANN-OLSON",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211430",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.