Jacqueline Williams, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

028534 Issued in NC

Practice address

800 Tilghman Dr
Dunn, NC 28334-5510

Phone

(910) 892-1000

Fax

(910) 891-6032

NPI assigned

Sep 13, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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.

• Lighthouse Anesthesia LLC

  • Anesthesiology Physician
  • Savannah, GA
  • NPI 1306036561
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841395290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 CHICORA CLUB DR",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345668",
            "telephone_number": "910-892-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TILGHMAN DR",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283345510",
            "telephone_number": "910-892-1000",
            "fax_number": "910-891-6032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACQUELINE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "028534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BOARD OF NURSING VERIC",
            "identifier": "042621",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luther B West III, PHARMD
• WH Pharmacy 2 LLC
• Forrest Wilke
• Auston Culeigh Williams III, DDS
• Auston Culeigh Williams Jr., D.D.S.
• John Michael Williams, D.D.S.
• Michelle Williams, OTRL
• Amy Watson Willis, BS-ITFS
• Miranda Elizabeth Willson, DPT
• Lisa Witthar, LCSW

• Certified Registered Nurse Anesthetist in Dunn, NC
• Providers in Dunn, NC by specialty
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.