Individual provider Active NPI

Tlyasha Williams

  • Clinical Laboratory Director (Non-physician)
  • Indianapolis, IN
National Provider Identifier
1568195253
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X
Practice address
3125 Dandy TRL Ste 220
Indianapolis, IN 46214-1460
Phone
(765) 734-0892
NPI assigned
Jul 8, 2022
Last updated
Jul 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Laboratory Director (Non-physician) 247ZC0005X Primary

Addresses

Primary practice location

3125 Dandy TRL Ste 220
Indianapolis, IN 46214-1460

Mailing address

3125 Dandy TRL Ste 220
Indianapolis, IN 46214-1460
Phone (765) 734-0892

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

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1568195253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 DANDY TRL STE 220",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462141460",
            "telephone_number": "765-734-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 DANDY TRL STE 220",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462141460",
            "telephone_number": "765-734-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TLYASHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.