Active NPI
Peaches Williams
- Home Health Aide
- Clinton, MS
National Provider Identifier
1790454916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 682
- Practice address
- 345 Woodstone Rd
Clinton, MS 39056-4945 - Phone
- (601) 473-1325
- NPI assigned
- Sep 10, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 682 | MS | Primary |
Addresses
Primary practice location
345 Woodstone Rd
Clinton, MS 39056-4945
Mailing address
1216 Hodge Lane
Edwards, MS 39066
Phone (601) 473-1325
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | AbundanceofloveandCare | Other |
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 |
|---|---|---|---|
| 682 | MS | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631232000000",
"number": "1790454916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1216 HODGE LANE",
"city": "EDWARDS",
"state": "MS",
"postal_code": "39066",
"telephone_number": "601-473-1325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 WOODSTONE RD",
"city": "CLINTON",
"state": "MS",
"postal_code": "390564945",
"telephone_number": "601-473-1325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "PEACHES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-10",
"last_updated": "2021-09-10",
"certification_date": "2021-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "MS",
"license": "682",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "AbundanceofloveandCare",
"affiliation": "N",
"endpointDescription": "Privatehomehealth",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Providingassistantwiththeneeded",
"address_1": "345 Woodstone Rd",
"city": "Clinton",
"state": "MS",
"country_code": "US",
"postal_code": "390564945",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Clinton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.