Individual provider Active NPI

Musu Olu Sonnie-Williams, NP

  • Nurse Practitioner
  • Caledonia, MI
National Provider Identifier
1407328107
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704215504 Issued in MI
Practice address
6897 Dale Hollow Dr SE
Caledonia, MI 49316-7815
Phone
(616) 648-3246
NPI assigned
Dec 19, 2018
Last updated
Nov 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704215504 MI Primary

Addresses

Primary practice location

6897 Dale Hollow Dr SE
Caledonia, MI 49316-7815

Mailing address

6897 Dale Hollow Dr SE
Caledonia, MI 49316-7815
Phone (616) 648-3246

Other identifiers 1

IdentifierTypeStateIssuer
MI8282OtherMIMI - MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191122001330 MI Practitioner - Nurse Practitioner 9133551559 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Global Medical Healthcare Incorporated CurrentSince Sep 21, 2019 Accepting new patients
Ayee Homecare LLC Current Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jun 6, 2024 Accepting new patients
Christian Global Medical Healthcare, Incorporated Current Accepting new patients

Locations

451 W Milham Ave
Portage, MI 49024
Phone (269) 488-9007

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 355-4719

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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, 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": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1407328107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6897 DALE HOLLOW DR SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167815",
            "telephone_number": "616-648-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6897 DALE HOLLOW DR SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167815",
            "telephone_number": "616-648-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONNIE-WILLIAMS",
        "first_name": "MUSU",
        "middle_name": "OLU",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704215504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI - MEDICARE",
            "identifier": "MI8282",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caledonia, MI

Sources for this page

Verify at the official NPI Registry.