Active NPI
Taylor Renee Williams, AU.D.
- Audiologist
- Jonesboro, AR
National Provider Identifier
1831840404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 201520
- Practice address
- 520 Carson St
Jonesboro, AR 72401-3128 - Phone
- (870) 336-2175
- NPI assigned
- Jan 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 201520 | AR | Primary |
Addresses
Primary practice location
520 Carson St
Jonesboro, AR 72401-3128
Mailing address
1805 Wedgewood Dr
Paragould, AR 72450-5357
Phone (870) 761-9633
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220317001298 | AR | Practitioner - Qualified Audiologist | 5991190589 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201520 | AR | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Ear Nose & Throat, P.a. | Single Specialty | Current | Accepting new patients |
Locations
11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215
4220 Richards Rd
North Little Rock, AR 72117
Phone (501) 975-7550
4020 Richards Rd
Ste B
North Little Rock, AR 72117
Phone (501) 202-4000
Organizations & group practices 1
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.
-
- Otolaryngology Physician
- North Little Rock, AR
- NPI 1609966530
AR, Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642118400000",
"number": "1831840404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 WEDGEWOOD DR",
"city": "PARAGOULD",
"state": "AR",
"postal_code": "724505357",
"telephone_number": "870-761-9633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 CARSON ST",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724013128",
"telephone_number": "870-336-2175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "TAYLOR",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-14",
"last_updated": "2022-01-14",
"certification_date": "2022-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Audiologist",
"state": "AR",
"license": "201520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.