Mariah A Williams
Individual provider Active NPI Physician Assistant · Liberty, NC
NPI 1497597306 · NPPES record last updated Dec 5, 2024
Key facts
- NPI
- 1497597306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0010-14484 (NC)
- Practice address
- 246 W Swannanoa Ave
Liberty, NC 27298-3214 - Phone
- (336) 795-2016
- NPI assigned
- Jun 11, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mainstreet and Kidsstreet of North Carolina PLLC
Practice addresses (Care Compare)
130 James Ave
Locust, NC 28097-4506
Phone (704) 296-4508
2151 N Church St
Burlington, NC 27217-3003
Phone (336) 329-0959
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241104001019 | NC | Practitioner - Physician Assistant | 8921531526 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainstreet and Kidsstreet of North Carolina PLLC | Current |
Accepting new patients | |
| Mainstreet and Kidsstreet of North Carolina PLLC | Current |
Accepting new patients |
Locations
1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088
130 James Ave
Locust, NC 28097
Phone (704) 271-3777
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-14484 | NC | Yes |
Addresses
Primary practice location
246 W Swannanoa Ave
Liberty, NC 27298-3214
Mailing address
5 Taylor St
Bloomington, NY 12411-5016
Phone (845) 901-9389
Other providers in Liberty, NC
- Daniel Patrick Waddell
- Michelle Waddell
- Wal-Mart Stores East, LP
- Wells Health and Wellness
- Cheryl Jean Wells
All providers in Liberty, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.