Individual provider Active NPI

Julie Vivian Williams, NP

  • Gerontology Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1487051173
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024172076 Issued in VA
Practice address
2000 Green Rd, Ste 300
Dept. of Emergency Medicine
Ann Arbor, MI 48105
Phone
(734) 712-1881
Fax
(804) 628-0384
NPI assigned
Nov 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024172076 VA Primary
Nurse Practitioner 363L00000X 4704339208 MI

Addresses

Primary practice location

2000 Green Rd, Ste 300
Dept. of Emergency Medicine
Ann Arbor, MI 48105

Mailing address

2000 Green Rd Ste 300
Ann Arbor, MI 48105-1575
Phone (734) 712-1881

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwilliams24638@direct.trinity-health.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180808003123 MI Practitioner - Nurse Practitioner 7012234313 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024172076VAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Mercy Hospital Current Accepting new patients
St Joseph Mercy Hospital CurrentSince Apr 3, 2019 Accepting new patients
St Joseph Mercy Hospital CurrentSince Apr 3, 2019 Accepting new patients

Locations

1600 S Canton Center Rd
Canton, MI 48188
Phone (734) 398-7557

34505 W 12 Mile Rd
Ste 200
Farmington Hills, MI 48331
Phone (734) 343-3922

7025 E Michigan Ave
Saline, MI 48176
Phone (734) 712-0020

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1487051173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GREEN RD STE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051575",
            "telephone_number": "734-712-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 GREEN RD, STE 300",
            "address_2": "DEPT. OF EMERGENCY MEDICINE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-712-1881",
            "fax_number": "804-628-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JULIE",
        "middle_name": "VIVIAN",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-25",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024172076",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704339208",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilliams24638@direct.trinity-health.org",
            "affiliation": "N",
            "address_1": "2000 Green RD, STE 300",
            "address_2": "Dept. of Emergency Medicine",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.