Keyanna D Williams

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Practice address

3605 Courtleigh Dr
Randallstown, MD 21133-4806

Phone

(443) 392-6934

NPI assigned

Jul 3, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• For 4Everblessed LLC

  • Assisted Living Facility
  • Randallstown, MD
  • NPI 1538847991

  Community/Behavioral Health

  NPD Authorized official

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1457038382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 CONCORD PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198035022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 COURTLEIGH DR",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334806",
            "telephone_number": "443-392-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KEYANNA",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamira White Tucker
• Midori Pavielle Starks White, MD
• Irvin Larry Wilder, DDS
• Alec James Wilkins, PA
• Brenda Williams-Whitehead
• Khalilah Williams
• Robert Williams
• Tiffany Samantha Williams, RN
• Pamela Yvette Willis, LCSW-C
• Mary Beth Winkeljohn, MS, CRNP-F

• Assisted Living Facility in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Assisted Living Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.