Individual provider Active NPI

Ondrea Williams, LPN

  • Licensed Practical Nurse
  • Concord, NC
National Provider Identifier
1841539764
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
74505 Issued in NC
Practice address
300 Copperfield Blvd NE
Suite 105
Concord, NC 28025-2428
Phone
(704) 782-3131
Fax
(704) 782-3133
NPI assigned
Feb 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 74505 NC Primary

Addresses

Primary practice location

300 Copperfield Blvd NE
Suite 105
Concord, NC 28025-2428

Mailing address

515 Clanton Rd
Charlotte, NC 28217-1309
Phone (704) 332-9001

Other names 1

  • Ondrea Nicole Dellisanti Former name

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
74505NCMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1841539764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 CLANTON RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171309",
            "telephone_number": "704-332-9001",
            "fax_number": "704-714-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COPPERFIELD BLVD NE",
            "address_2": "SUITE 105",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252428",
            "telephone_number": "704-782-3131",
            "fax_number": "704-782-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ONDREA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-13",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "74505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ONDREA",
            "last_name": "DELLISANTI",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.