Individual provider Active NPI

Jennelle Saunders Williams, MD

  • Dermatology Physician
  • Chapel Hill, NC
National Provider Identifier
1407837271
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
9700811 Issued in NC
Practice address
2238 Nelson Hwy
Ste 100
Chapel Hill, NC 27517-8914
Phone
(919) 401-1994
Fax
(919) 401-1924
NPI assigned
Nov 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 9700811 NC Primary

Addresses

Primary practice location

2238 Nelson Hwy
Ste 100
Chapel Hill, NC 27517-8914

Mailing address

2238 Nelson Hwy
Ste 100
Chapel Hill, NC 27517-8914
Phone (919) 401-1994

Other identifiers 2

IdentifierTypeStateIssuer
890101KMedicaidNC
9700811OtherNC LIC

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9700811NCMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1407837271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2238 NELSON HWY",
            "address_2": "STE 100",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275178914",
            "telephone_number": "919-401-1994",
            "fax_number": "919-401-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2238 NELSON HWY",
            "address_2": "STE 100",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275178914",
            "telephone_number": "919-401-1994",
            "fax_number": "919-401-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNELLE",
        "middle_name": "SAUNDERS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "9700811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890101K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LIC",
            "identifier": "9700811",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.