Active NPI
Annie Jean Williams
- Home Health Aide
- Saint Louis, MO
National Provider Identifier
1457452948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 0003703
- Practice address
- 716 S Florissant Rd
Saint Louis, MO 63135-2984 - Phone
- (314) 522-6414
- Fax
- (314) 522-1934
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0003703 | MO | |
| Chore Provider | 372500000X | 0003703 | MO | |
| Home Health Aide | 374U00000X | 0003703 | MO | Primary |
| Homemaker | 376J00000X | 0003703 | MO | |
| Respite Care | 385H00000X |
Addresses
Primary practice location
716 S Florissant Rd
Saint Louis, MO 63135-2984
Mailing address
716 S Florissant Rd
Saint Louis, MO 63135-2984
Phone (314) 522-6414
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 289738403 | Medicaid | MO | |
| 269738407 | Medicaid | MO |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0003703 | MO | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488499200000",
"number": "1457452948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 S FLORISSANT RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631352984",
"telephone_number": "314-522-6414",
"fax_number": "314-522-1934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 S FLORISSANT RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631352984",
"telephone_number": "314-522-6414",
"fax_number": "314-522-1934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "ANNIE",
"middle_name": "JEAN",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2017-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "0003703",
"primary": false
},
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": "MO",
"license": "0003703",
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "MO",
"license": "0003703",
"primary": true
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "MO",
"license": "0003703",
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "289738403",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "269738407",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.