Active NPI
Andrea Denise Williams
- Home Health Aide
- Jackson, MS
National Provider Identifier
1588100697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 801544000
- Practice address
- 319 Knob Hill Dr
227 Kilmaine Court
Jackson, MS 39209-2822 - Phone
- (601) 850-6487
- Fax
- (601) 960-1776
- NPI assigned
- Jan 12, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 801544000 | MS | Primary |
Addresses
Primary practice location
319 Knob Hill Dr
227 Kilmaine Court
Jackson, MS 39209-2822
Mailing address
319 Knob Hill Dr
227 Kilmaine Court
Jackson, MS 39209-2822
Phone (601) 850-6487
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 801544000 | MS | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484179200000",
"number": "1588100697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319 KNOB HILL DR",
"address_2": "227 KILMAINE COURT",
"city": "JACKSON",
"state": "MS",
"postal_code": "392092822",
"telephone_number": "601-850-6487",
"fax_number": "601-960-1776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 KNOB HILL DR",
"address_2": "227 KILMAINE COURT",
"city": "JACKSON",
"state": "MS",
"postal_code": "392092822",
"telephone_number": "601-850-6487",
"fax_number": "601-960-1776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "ANDREA",
"middle_name": "DENISE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-12",
"last_updated": "2017-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "MS",
"license": "801544000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.