Jessica Antoinette Williams

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

32014 Issued in MN

Practice address

1705 Anne St NW
Bemidji, MN 56601-6151

Phone

(218) 751-3280

NPI assigned

Feb 25, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sanford Health of Northern MinnesotaGroup PAC ID 5597725168, shared by 21 NPIs, 349 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sanford Health of Northern Minnesota

  dba Sanford Health Behavioral Health Administration Office

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bemidji, MN
  • NPI 1427567601

  GA

  Medicare reassignment NPD
• Sanford Health of Northern Minnesota

  dba Sanford Health Kelliher Clinic

  • Family Medicine Physician
  • Kelliher, MN
  • NPI 1770849697
  Medicare reassignment NPD
• Sanford Health of Northern Minnesota

  dba Joe Lueken Cancer Center

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149
  NPD

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

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1740502293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566016151",
            "telephone_number": "218-751-3280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3444 Friendship Farm Dr",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305191957",
            "country_code": "US",
            "telephone_number": "770-616-6373",
            "fax_number": "770-616-6373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JESSICA",
        "middle_name": "ANTOINETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW008349",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "32014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney D Will, MD
• Baret Williams-Furfaro
• Douglas Russell Williams, D.D.S
• Emily Williams, RN, BSN, PHN, LSN
• Jessica Williams, APN
• Travis J. Williams, D.O.
• Amanda Willis-Martin, LADC
• Hannah Wilson, LPCC
• Sarah Jean Winter, RN
• Casey Witkin

• Clinical Social Worker in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.