Active NPI
Tristen James Estefano Williams, CNA
- Child Physical Disabilities Respite Care
- Omaha, NE
National Provider Identifier
1629880646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child Physical Disabilities Respite Care
- Practice address
- 5562 S 122ND St
Omaha, NE 68137-3423 - Phone
- (402) 980-4689
- NPI assigned
- Jan 25, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chore Provider | 372500000X | NE | ||
| Child Physical Disabilities Respite Care | 385HR2065X | NE | Primary | |
| Personal Care Attendant | 3747P1801X | NE |
Addresses
Primary practice location
5562 S 122ND St
Omaha, NE 68137-3423
Mailing address
14834 Walnut Grove Cir
Omaha, NE 68137-1462
Phone (402) 960-5501
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": "1737763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737763200000",
"number": "1629880646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14834 WALNUT GROVE CIR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681371462",
"telephone_number": "402-960-5501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5562 S 122ND ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681373423",
"telephone_number": "402-980-4689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "TRISTEN",
"middle_name": "JAMES ESTEFANO",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-25",
"last_updated": "2025-01-25",
"certification_date": "2025-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": "NE",
"license": null,
"primary": false
},
{
"code": "385HR2065X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Physical Disabilities, Child",
"state": "NE",
"license": null,
"primary": true
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "NE",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.