Individual provider Active NPI

Kristina Williams

  • Pharmacist
  • Statesboro, GA
National Provider Identifier
1386150514
Registry record updated Sep 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH026862 Issued in GA
Practice address
101 Tormenta Way
Statesboro, GA 30458-5697
Phone
(912) 243-6225
NPI assigned
Dec 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X RPH026862 GA Primary

Addresses

Primary practice location

101 Tormenta Way
Statesboro, GA 30458-5697

Mailing address

104 Stonebrook Way
Statesboro, GA 30458-0286
Phone (912) 486-4357

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
RPH026862GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets, Inc. CurrentSince Oct 1, 2023 Accepting new patients

Locations

101 Tormenta Way
Statesboro, GA 30458
Phone (912) 243-6225

Organizations & group practices 1

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": "1514246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696032000000",
    "number": "1386150514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 STONEBROOK WAY",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580286",
            "telephone_number": "912-486-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 TORMENTA WAY",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585697",
            "telephone_number": "912-243-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KRISTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-26",
        "last_updated": "2023-09-30",
        "certification_date": "2023-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH026862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2023; 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.