Kelly Angelic Williams, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN.172052.MEDSIV Issued in OH

Practice address

4222 Southway St SW
Massillon, OH 44646-9325

Phone

(330) 974-7024

NPI assigned

Feb 27, 2023

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 names 1

• Kelly Lamp Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1851090120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 SOUTHWAY ST SW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469325",
            "telephone_number": "330-974-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 SOUTHWAY ST SW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469325",
            "telephone_number": "330-974-7024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Sixth St SW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447101702",
            "country_code": "US",
            "telephone_number": "330-830-3393",
            "fax_number": "234-521-7091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KELLY",
        "middle_name": "ANGELIC",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.172052.MEDSIV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "LAMP",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carrie Wiesen
• Raegan L Wigfield, RMA/STNA
• Jefferie Michael Wilhelm, NP-C
• Adam Williams
• Constance Kay Williams, MT(ASCP)
• Mia L Williams, LPN
• Raquel Lyn Williams
• Scott D. Williams, M.D.
• Mary G Willis
• Sarina Wills

• Licensed Practical Nurse in Massillon, OH
• Providers in Massillon, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.