NPIMap

Individual provider Active NPI

Paulette Williams, CDE, RD, & LD

  • Registered Dietitian
  • Clayton, GA
National Provider Identifier
1376735399
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD000046 Issued in GA
Practice address
790 N Main St
Suite 101
Clayton, GA 30525-4275
Phone
(404) 234-6570
Fax
(706) 782-1840
NPI assigned
Aug 14, 2007
Last updated
Oct 26, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 315876 GA
Registered Dietitian 133V00000X LD000046 GA Primary

Addresses

Primary practice location

790 N Main St
Suite 101
Clayton, GA 30525-4275

Mailing address

227 S Pendleton St
Suite B
Easley, SC 29640-3047
Phone (864) 855-7030

Other identifiers 1

IdentifierTypeStateIssuer
71BBBWMOtherGAPTAN/LEGACY

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
315876GAMDRegistered Dietitian
LD000046GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Beck's Healthcare, LLC Past Accepting new patients
Beck's Healthcare, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1376735399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 S PENDLETON ST",
            "address_2": "SUITE B",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296403047",
            "telephone_number": "864-855-7030",
            "fax_number": "864-855-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 N MAIN ST",
            "address_2": "SUITE 101",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305254275",
            "telephone_number": "404-234-6570",
            "fax_number": "706-782-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PAULETTE",
        "credential": "CDE, RD, & LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "315876",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD000046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN/LEGACY",
            "identifier": "71BBBWM",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.