Shelby Lane Williams, PA-C, RDN

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9116779 Issued in FL

Practice address

106 Boston Ave Ste 100
Altamonte Springs, FL 32701-4712

Phone

(800) 827-7546

NPI assigned

Mar 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1457051856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 690609",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328690609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BOSTON AVE STE 100",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327014712",
            "telephone_number": "800-827-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHELBY",
        "middle_name": "LANE",
        "name_prefix": "Mrs.",
        "credential": "PA-C, RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lavet E Williams
• Marcus Orene Williams III, DMD
• Mark Clay Williams, PHD
• Monica Williams, RMHCI
• Sheila D Williams, PH.D.
• Steve K Williams, MD
• Tashayla Williams
• Traci Michelle Williams, M.S.
• Traevioynah Williams
• Gloria Ann Wilson

• Physician Assistant in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.