Individual provider Active NPI

Denisha Louise Williams, HAIR LOSS SPECIALIST

  • Prosthetist
  • Gulfport, MS
National Provider Identifier
1750906301
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
0013087 Issued in MS
Practice address
828 Pass Rd Ste C
Gulfport, MS 39501-6437
Phone
(228) 547-4074
NPI assigned
Jun 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X 0013087 MS Primary

Addresses

Primary practice location

828 Pass Rd Ste C
Gulfport, MS 39501-6437

Mailing address

828 Pass Rd Ste C
Gulfport, MS 39501-6437
Phone (228) 547-4074

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

LicenseStateTypeSpecialty
0013087MSMDProsthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Hair Loss Center Prosthetist CurrentSince Aug 30, 2020 Accepting new patients
Xquisite Haar Loss Restoration Center LLC Prosthetist CurrentSince Jun 21, 2020 Accepting new patients

Locations

828 Pass Rd
Ste C
Gulfport, MS 39501
Phone (228) 547-4074

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1750906301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 PASS RD STE C",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395016437",
            "telephone_number": "228-547-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 PASS RD STE C",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395016437",
            "telephone_number": "228-547-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DENISHA",
        "middle_name": "LOUISE",
        "credential": "HAIR LOSS SPECIALIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "MS",
            "license": "0013087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.