Kimberly Williams

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Practice address

4080 E Lake Mead Blvd Ste B-111
Las Vegas, NV 89115-6466

Phone

(702) 629-8226

NPI assigned

Feb 21, 2020

Last updated

Feb 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1477186070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 E LAKE MEAD BLVD STE B-111",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891156466",
            "telephone_number": "702-629-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 E LAKE MEAD BLVD STE B-111",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891156466",
            "telephone_number": "702-629-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6613776020",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lvangelcare@yahoo.com",
            "affiliation": "N",
            "address_1": "4080 E Lake Mead Blvd Ste B-111",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891156466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin Williams
• Kevin Clifford Williams
• Keyarro Williams
• Keyokia Williams
• Kiara Williams
• Kimberly Williams
• Kimberly S Williams
• Kiya Williams
• Kobe Williams
• Kourtney Williams

• In Home Supportive Care Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• In Home Supportive Care Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.