Individual provider Active NPI

Zackery O Williams

  • Contractor
  • Milwaukee, WI
National Provider Identifier
1801689195
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
W4529948300307 Issued in WI
Practice address
1435 N 50TH St
Milwaukee, WI 53208-2208
Phone
(407) 451-7201
NPI assigned
May 28, 2025
Last updated
May 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X W4529948300307 WI Primary

Addresses

Primary practice location

1435 N 50TH St
Milwaukee, WI 53208-2208

Mailing address

1435 N 50TH St
Milwaukee, WI 53208-2208
Phone (407) 451-7201

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
W4529948300307WIMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1801689195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 N 50TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532082208",
            "telephone_number": "407-451-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 N 50TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532082208",
            "telephone_number": "407-451-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ZACKERY",
        "middle_name": "O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "WI",
            "license": "W4529948300307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.