Active NPI
Lisa Victoria Williams, PA
- Physician Assistant
- Lake Havasu City, AZ
National Provider Identifier
1437163557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2884
- Practice address
- 101 Civic Center LN
Lake Havasu City, AZ 86403-5607 - Phone
- (928) 453-0150
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2884 | AZ | Primary |
Addresses
Primary practice location
101 Civic Center LN
Lake Havasu City, AZ 86403-5607
Mailing address
2336 Regatta CT
Lake Havasu City, AZ 86404-2042
Phone (928) 566-7337
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2884 | AZ | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217808000000",
"number": "1437163557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2336 REGATTA CT",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864042042",
"telephone_number": "928-566-7337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CIVIC CENTER LN",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864035607",
"telephone_number": "928-453-0150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "LISA",
"middle_name": "VICTORIA",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2008-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "2884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Havasu City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.