Active NPI
Carolyn Cordelia Williams, MAPT
- Physical Therapist
- Detroit, MI
National Provider Identifier
1598896466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501000685
- Practice address
- 2301 Van Dyke St
Detroit, MI 48214-3958 - Phone
- (313) 866-7363
- Fax
- (313) 866-7482
- NPI assigned
- Mar 9, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501000685 | MI | Primary |
Addresses
Primary practice location
2301 Van Dyke St
Detroit, MI 48214-3958
Mailing address
9000 E Jefferson Ave
Apt. # 24-12
Detroit, MI 48214-4188
Phone (313) 822-9577
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501000685 | Other | MI | PHYSICAL THERAPY 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501000685 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598896466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 E JEFFERSON AVE",
"address_2": "APT. # 24-12",
"city": "DETROIT",
"state": "MI",
"postal_code": "482144188",
"telephone_number": "313-822-9577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 VAN DYKE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482143958",
"telephone_number": "313-866-7363",
"fax_number": "313-866-7482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "CAROLYN",
"middle_name": "CORDELIA",
"name_prefix": "Ms.",
"credential": "MAPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501000685",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY LICENSE",
"identifier": "5501000685",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.