Individual provider Active NPI

Christian Demor Williams, FNP

  • Family Nurse Practitioner
  • Canton, GA
National Provider Identifier
1659297059
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN321036 Issued in GA
Practice address
2000 Village Professional Dr Ste 110
Canton, GA 30114-8499
Phone
(678) 880-6698
Fax
(470) 299-9936
NPI assigned
Jun 29, 2026
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN321036 GA Primary

Addresses

Primary practice location

2000 Village Professional Dr Ste 110
Canton, GA 30114-8499

Mailing address

130 Vines CT
Fayetteville, GA 30215-8236
Phone (478) 293-8610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1782691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1659297059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 VINES CT",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302158236",
            "telephone_number": "478-293-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 VILLAGE PROFESSIONAL DR STE 110",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148499",
            "telephone_number": "678-880-6698",
            "fax_number": "470-299-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CHRISTIAN",
        "middle_name": "DEMOR",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-29",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN321036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.