Individual provider Active NPI

Darla Jo Williams, R.N.

  • Registered Nurse
  • Granite City, IL
National Provider Identifier
1689820052
Registry record updated Aug 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041322090 Issued in IL
Practice address
2100 Madison Ave
Granite City, IL 62040-4701
Phone
(618) 798-3000
NPI assigned
Aug 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041322090 IL Primary

Addresses

Primary practice location

2100 Madison Ave
Granite City, IL 62040-4701

Mailing address

2334 Waterman Ave
Granite City, IL 62040-4023
Phone (618) 979-0545

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041322090ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1218931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218931200000",
    "number": "1689820052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 WATERMAN AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404023",
            "telephone_number": "618-979-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MADISON AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404701",
            "telephone_number": "618-798-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DARLA",
        "middle_name": "JO",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-17",
        "last_updated": "2008-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041322090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2008; 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.