Active NPI
Rayana Williams
- Licensed Practical Nurse
- Hartford, CT
National Provider Identifier
1710561519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 40914
- Practice address
- 55 Fishfry St
Hartford, CT 06120-1203 - Phone
- (860) 247-8300
- NPI assigned
- May 7, 2021
- Last updated
- May 7, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 40914 | CT | Primary |
Addresses
Primary practice location
55 Fishfry St
Hartford, CT 06120-1203
Mailing address
266 Castlewood Dr
Bloomfield, CT 06002-1370
Phone (860) 680-4531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40914 | Medicaid | CT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40914 | CT | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Substance Abuse Centers, Inc. | Licensed Practical Nurse | Past | Accepting new patients |
| Community Physicians PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Health Care Resource Centers
- Substance Use Disorder Rehabilitation Clinic/Center
- Hartford, CT
- NPI 1487637724
Licensed Practical Nurse
-
- Methadone Clinic
- Portland, ME
- NPI 1316242209
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620345600000",
"number": "1710561519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "266 CASTLEWOOD DR",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060021370",
"telephone_number": "860-680-4531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FISHFRY ST",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061201203",
"telephone_number": "860-247-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "RAYANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-07",
"last_updated": "2021-05-07",
"certification_date": "2021-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CT",
"license": "40914",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40914",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.