Candace Charisse Williams, MS, OTR/L

Primary specialty

Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X

License

OC018008 Issued in PA

Practice address

487 E Moorestown Rd Ste 112
Wind Gap, PA 18091-9683

Phone

(347) 642-0936

NPI assigned

Jan 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Mobile Therapy Services, Inc.

  • Physical Therapist
  • Ocean, NJ
  • NPI 1326495615

  NJ

  Medicare reassignment NPD

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1821749201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2379 MILAN ST BLDG D",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455791",
            "telephone_number": "347-642-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 E MOORESTOWN RD STE 112",
            "city": "WIND GAP",
            "state": "PA",
            "postal_code": "180919683",
            "telephone_number": "347-642-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CANDACE",
        "middle_name": "CHARISSE",
        "name_prefix": "Ms.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "PA",
            "license": "OC018008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "candace.williams@sluhn.org",
            "affiliation": "Y",
            "endpointDescription": "Business E-Mail",
            "affiliationName": "St. Luke's Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "487 E Moorestown Rd Ste 112",
            "city": "Wind Gap",
            "state": "PA",
            "country_code": "US",
            "postal_code": "180919683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Beth Anne Votral, DPT
• Donna M Wallinger-Corvino, DMD
• Abbigail Walsh
• F. Joseph Werner, O.D.
• Regan Whitesell, M. ED.
• Wind Gap Ambulance Corps Inc
• Wind Gap Community Pharmacy Inc
• Wind Gap Community Pharmacy Inc
• Melat Tiruneh Worku, MD
• Ken Zhongyu Zhang, MD

• All providers in Wind Gap, PA
• Neurorehabilitation Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.