Individual provider Active NPI

Jonathan Edward Williams

  • Student in an Organized Health Care Education/Training Program
  • Ann Arbor, MI
National Provider Identifier
1467075580
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1500 E Medical Center Dr. SPC 5332
Taubman Center, Second Floor, Reception F
Ann Arbor, MI 48109-5332
Phone
(734) 936-5738
NPI assigned
May 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301508780 MI
Student in an Organized Health Care Education/Training Program 390200000X MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr. SPC 5332
Taubman Center, Second Floor, Reception F
Ann Arbor, MI 48109-5332

Mailing address

1500 E Medical Center Dr., SPC 5332
Taubman Center, Second Floor, Reception F
Ann Arbor, MI 48109-5332

Other practice location 1

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 593-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwilliams6323139@direct.beaumont.edu

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301508780MIMDSurgery Physician

Interoperability endpoints

  • Direct secure messaging: jwilliams1460437@epic00.shdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1467075580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR., SPC 5332",
            "address_2": "TAUBMAN CENTER, SECOND FLOOR, RECEPTION F",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR. SPC 5332",
            "address_2": "TAUBMAN CENTER, SECOND FLOOR, RECEPTION F",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095332",
            "telephone_number": "734-936-5738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18101 Oakwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244089",
            "country_code": "US",
            "telephone_number": "313-593-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JONATHAN",
        "middle_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-22",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301508780",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilliams6323139@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "18101 Oakwood Blvd",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481244089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.