Active NPI
Mary Jo Williams, PTA
- Physical Therapy Assistant
- Omaha, NE
National Provider Identifier
1497026215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 976
- Practice address
- 2211 S 152ND St
Omaha, NE 68144-1906 - Phone
- (402) 697-0669
- NPI assigned
- Jan 25, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 976 | NE | Primary |
Addresses
Primary practice location
2211 S 152ND St
Omaha, NE 68144-1906
Mailing address
2211 S 152ND St
Omaha, NE 68144-1906
Phone (402) 697-0669
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 |
|---|---|---|---|
| 976 | NE | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327449600000",
"number": "1497026215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2211 S 152ND ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681441906",
"telephone_number": "402-697-0669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 S 152ND ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681441906",
"telephone_number": "402-697-0669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MARY JO",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-25",
"last_updated": "2012-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NE",
"license": "976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.