Active NPI
Randall Williams, D.C.
- Chiropractor
- Grandville, MI
National Provider Identifier
1669521605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- RW007561
- Practice address
- 3000 Ivanrest Ave SW
Suite D
Grandville, MI 49418-2943 - Phone
- (616) 532-5291
- NPI assigned
- Jan 9, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | RW007561 | MI | Primary |
Addresses
Primary practice location
3000 Ivanrest Ave SW
Suite D
Grandville, MI 49418-2943
Mailing address
3000 Ivanrest Ave SW
Suite D
Grandville, MI 49418-2943
Phone (616) 532-5291
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RW007561 | MI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Michigan Rehabilitation Center Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Wyoming, MI
- NPI 1376628446
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196726400000",
"number": "1669521605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 IVANREST AVE SW",
"address_2": "SUITE D",
"city": "GRANDVILLE",
"state": "MI",
"postal_code": "494182943",
"telephone_number": "616-532-5291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 IVANREST AVE SW",
"address_2": "SUITE D",
"city": "GRANDVILLE",
"state": "MI",
"postal_code": "494182943",
"telephone_number": "616-532-5291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "RANDALL",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2007-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "RW007561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grandville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.