Demetrius Williams, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

905371 Issued in MS

Practice address

1150 W Causeway Approach
Mandeville, LA 70471-3038

Phone

(866) 530-6111

NPI assigned

Jul 7, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: demetrius.williams.1@11331.direct.athenahealth.com

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1578296489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18679",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394048679",
            "telephone_number": "601-705-1901",
            "fax_number": "601-705-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 W CAUSEWAY APPROACH",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713038",
            "telephone_number": "866-530-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DEMETRIUS",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-07",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "905371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Wilkins Jr.
• William R. Ledoux D.D.S. a.P.D.C.
• Abigail Williams
• Anita Roshelle Williams
• Delacia Williams, PMHNP
• Myreka Richelle Williams
• Ruston Lee Williams, D.C.
• Trudy Meyers Williams, RD, LDN
• Wilbert Lee Williams Jr.
• Rebecca Willingham, PMHNP

• Psychiatric/Mental Health Nurse Practitioner in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.