Mirenda Latisa Williams, AGNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

5007484 Issued in NC

Practice address

2365 Springs Rd NE
Hickory, NC 28601-3067

Phone

(828) 325-0950

Fax

(828) 325-0248

NPI assigned

Mar 9, 2015

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Springs Road Consulting LLC

  • Internal Medicine Physician
  • Hickory, NC
  • NPI 1649623703
  NPD (past)

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1801289368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 KARLBROOK LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276166199",
            "telephone_number": "919-491-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 SPRINGS RD NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013067",
            "telephone_number": "828-325-0950",
            "fax_number": "828-325-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MIRENDA",
        "middle_name": "LATISA",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-09",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5007484",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5007484",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Paul Williams
• Larry Williams, MD
• Leah Kimberly Williams, LMT
• Makenna Williams, RBT
• Mark O Williams
• Robert C. Williams, M.D.
• Stephanie Marshall Williams
• Thomas Reginald Williams, M.D.
• Ashley Nichols Williamson, HIS
• Steven G Williamson, MD

• Adult Health Nurse Practitioner in Hickory, NC
• Providers in Hickory, NC by specialty
• Adult Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.