Individual provider Active NPI

Roman Williams

  • Home Health Agency
  • Cordova, TN
National Provider Identifier
1619463197
Registry record updated Jul 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
8765 Gum Tree CV
Cordova, TN 38018-7659
Phone
(901) 215-5750
NPI assigned
Jul 8, 2018
Last updated
Jul 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

8765 Gum Tree CV
Cordova, TN 38018-7659

Mailing address

8765 Gum Tree CV
Cordova, TN 38018-7659

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": "1531008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531008000000",
    "number": "1619463197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8765 GUM TREE CV",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8765 GUM TREE CV",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187659",
            "telephone_number": "901-215-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ROMAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-08",
        "last_updated": "2018-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.