Individual provider Active NPI

Cassandra Nicole Williams, RN

  • Community Health Registered Nurse
  • Plymouth, MA
National Provider Identifier
1578039442
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN2318373 Issued in MA
Practice address
10 Cordage Park Cir
Plymouth, MA 02360-7318
Phone
(508) 778-5470
NPI assigned
Oct 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN2318373 MA Primary

Addresses

Primary practice location

10 Cordage Park Cir
Plymouth, MA 02360-7318

Mailing address

23 Ponderosa Dr
Hanover, MA 02339-1170
Phone (508) 292-5857

Other identifiers 1

IdentifierTypeStateIssuer
RN2318373OtherMARN LICENSE

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2318373MAMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1578039442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 PONDEROSA DR",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023391170",
            "telephone_number": "508-292-5857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CORDAGE PARK CIR",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023607318",
            "telephone_number": "508-778-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CASSANDRA",
        "middle_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "MA",
            "license": "RN2318373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN2318373",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.