Active NPI
Zachary Marshall Williams, FNP-C
- Family Nurse Practitioner
- Shenandoah, TX
National Provider Identifier
1407555360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1112778
- Practice address
- 121 Vision Park Blvd Ste 200
Shenandoah, TX 77384-3027 - Phone
- (281) 725-6767
- NPI assigned
- Mar 1, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 962690 | TX | |
| Family Nurse Practitioner | 363LF0000X | 1112778 | TX | Primary |
Addresses
Primary practice location
121 Vision Park Blvd Ste 200
Shenandoah, TX 77384-3027
Mailing address
8840 Lakeshore Dr
Montgomery, TX 77316-2400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 23, 2023 through Oct 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 962690 | TX | MD | Pediatrics Physician |
| 1112778 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1407555360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8840 LAKESHORE DR",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773162400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 VISION PARK BLVD STE 200",
"city": "SHENANDOAH",
"state": "TX",
"postal_code": "773843027",
"telephone_number": "281-725-6767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "ZACHARY",
"middle_name": "MARSHALL",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-01",
"last_updated": "2023-03-13",
"certification_date": "2023-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "962690",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1112778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shenandoah, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.