Active NPI
Andre Williams
- Other Technician
- Wendell, NC
National Provider Identifier
1588057913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 110 Aj Lane
Wendell, NC 27576 - Phone
- (203) 534-8663
- NPI assigned
- Mar 10, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | Primary |
Addresses
Primary practice location
110 Aj Lane
Wendell, NC 27576
Mailing address
110 Aj LN
Selma, NC 27576-9428
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": "1425945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426032000000",
"number": "1588057913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 AJ LN",
"city": "SELMA",
"state": "NC",
"postal_code": "275769428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 AJ LANE",
"city": "WENDELL",
"state": "NC",
"postal_code": "27576",
"telephone_number": "203-534-8663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "ANDRE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-10",
"last_updated": "2015-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wendell, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.