Individual provider Active NPI

Jerald Williams

  • Prosthetics Case Management
  • Humble, TX
National Provider Identifier
1396494274
Registry record updated Mar 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
672836 Issued in TX
Practice address
320 E Main St Ste D
Humble, TX 77338-4568
Phone
(281) 318-9462
NPI assigned
Mar 20, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X 672836 TX Primary

Addresses

Primary practice location

320 E Main St Ste D
Humble, TX 77338-4568

Mailing address

320 E Main St Ste D
Humble, TX 77338-4568

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
672836TXMDProsthetics Case Management

Practice roles

OrganizationSpecialtyStatusNew patients
Muzik the Barber LLC Prosthetics Case Management Current Accepting new patients

Locations

320 E Main St
Ste D
Humble, TX 77338
Phone (281) 318-9462

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": "1647734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647734400000",
    "number": "1396494274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E MAIN ST STE D",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E MAIN ST STE D",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384568",
            "telephone_number": "281-318-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JERALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-20",
        "last_updated": "2022-03-20",
        "certification_date": "2022-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "TX",
            "license": "672836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2022; 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.