Tyisha J Williams

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

3653063 Issued in OH

Practice address

2704 Volney Rd
Youngstown, OH 44511

Phone

(330) 639-5571

NPI assigned

Jul 7, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1437671856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 VOLNEY RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445112303",
            "telephone_number": "330-639-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 VOLNEY RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44511",
            "telephone_number": "330-639-5571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "618 Exeter Ave SW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447101765",
            "country_code": "US",
            "telephone_number": "330-639-5571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TYISHA",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": "3653063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0145005",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serenity Ann Williams
• Shaneka Williams
• Sharell Shanta Williams
• Takeisha Williams
• Taneasha Monique Williams
• Deaver Williamson
• Jadyn Williamson
• Marquis Williamson
• Tracey Williamson, LPN
• Tyra Willingham

• Home Health Aide in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Home Health Aide in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.