Raven Shanise Williams, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-1504 Issued in AR

Practice address

900 N 7TH St
West Memphis, AR 72301-2001

Phone

(870) 293-0594

Fax

(870) 394-9476

NPI assigned

May 18, 2019

Last updated

Jun 24, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, MS2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: raven.burrell.p1@direct.deltahc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wesley Community Center Inc

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1396910436
  Medicare reassignment
• Delta Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Ruleville, MS
  • NPI 1750937108
  NPD
• Wesley Community Center, Inc

  dba Wesley Community & Health Centers

  • Federally Qualified Health Center (FQHC)
  • Mesa, AZ
  • NPI 1699431726
  NPD

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

{
    "created_epoch": "1558137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1528624160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N 7TH ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723012001",
            "telephone_number": "870-735-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 7TH ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723012001",
            "telephone_number": "870-293-0594",
            "fax_number": "870-394-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RAVEN",
        "middle_name": "SHANISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-18",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8040",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00656",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-1504",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6260",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Mae Williams, DDS
• Denise Williams
• Latrice Williams
• Marlo S. Williams
• Mary Williams
• Tawanna Williams
• Julie Wilson, LCSW
• Raquel Wilson, PMHNP-BC
• Taylor Danielle Wilson
• Jasmine C Winda

• Physician Assistant in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.