Individual provider Active NPI

Tishelia Anthonic Williams, CNA

  • Other Technician
  • Detroit, MI
National Provider Identifier
1811446313
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
400 Renaissance Ctr Ste 2600
Detroit, MI 48243-1502
Phone
(888) 922-2843
Fax
(855) 568-2494
NPI assigned
Sep 25, 2016
Last updated
Oct 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Primary

Addresses

Primary practice location

400 Renaissance Ctr Ste 2600
Detroit, MI 48243-1502

Mailing address

18726 S Western Ave Ste 408
Gardena, CA 90248-3858
Phone (310) 856-0800

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

NPI Registry JSON

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

{
    "created_epoch": "1474761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1811446313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18726 S WESTERN AVE STE 408",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483858",
            "telephone_number": "310-856-0800",
            "fax_number": "855-568-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RENAISSANCE CTR STE 2600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482431502",
            "telephone_number": "888-922-2843",
            "fax_number": "855-568-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TISHELIA",
        "middle_name": "ANTHONIC",
        "name_prefix": "Ms.",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-25",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

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

Verify at the official NPI Registry.