Active NPI
Garland Bruce Williams Jr., FNPC
- Nurse Practitioner
- Burgaw, NC
National Provider Identifier
1487642146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 200258
- Practice address
- 301 S Campbell St
Burgaw, NC 28425-5011 - Phone
- (910) 259-6973
- Fax
- (910) 259-6975
- NPI assigned
- Oct 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 200258 | NC | Primary |
Addresses
Primary practice location
301 S Campbell St
Burgaw, NC 28425-5011
Mailing address
301 S Campbell St
Burgaw, NC 28425-5011
Phone (910) 259-6973
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
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368144000000",
"number": "1487642146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 S CAMPBELL ST",
"city": "BURGAW",
"state": "NC",
"postal_code": "284255011",
"telephone_number": "910-259-6973",
"fax_number": "910-259-6975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S CAMPBELL ST",
"city": "BURGAW",
"state": "NC",
"postal_code": "284255011",
"telephone_number": "910-259-6973",
"fax_number": "910-259-6975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "GARLAND",
"middle_name": "BRUCE",
"name_suffix": "Jr.",
"credential": "FNPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-07",
"last_updated": "2013-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "200258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burgaw, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.