Antoinette Shanae' Williams, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110008588 Issued in VA

Practice address

2035 Waterside Rd Ste 105
Prince George, VA 23875-1265

Phone

(804) 256-8282

Fax

(804) 256-8288

NPI assigned

Aug 2, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Vitalcare Family LLCGroup PAC ID 6709132731, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vitalcare Family LLC

  • Family Medicine Physician
  • Chesterfield, VA
  • NPI 1205337417
  Medicare reassignment Care Compare group
• Kurt R. Jung, Optometrist & Associates PLLC

  • Optometrist
  • Midlothian, VA
  • NPI 1699276998
  NPD (past)
• Nourish2Flourishrva LLC

  • Registered Dietitian
  • Midlothian, VA
  • NPI 1548636350
  NPD (past)

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1437886348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 ASHLAKE PKWY STE 200",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238322827",
            "telephone_number": "804-256-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 WATERSIDE RD STE 105",
            "city": "PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238751265",
            "telephone_number": "804-256-8282",
            "fax_number": "804-256-8288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7300 Ashlake Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "VA",
            "postal_code": "238322827",
            "country_code": "US",
            "telephone_number": "804-256-8282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8006 Discovery Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Henrico",
            "state": "VA",
            "postal_code": "232298600",
            "country_code": "US",
            "telephone_number": "804-256-8282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANTOINETTE",
        "middle_name": "SHANAE'",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0110008588",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0110008588",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Welcome Home Community Services, LLC
• Welcome Home Community Services, LLC
• Welcome Home Counseling, LLC
• Stephanie White
• Joyce Ann Wiggins
• Marqita Williams
• Erin Marie Winters
• Sara E Worthington, M.S., CCC-SLP
• Thomas Matlock Wyman, OD
• Cassandra Frances Wyrick

• Physician Assistant in Prince George, VA
• Providers in Prince George, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.