Individual provider Active NPI

Desiree Janine Williams, DPT

  • Orthopedic Physical Therapist
  • Playa del Rey, CA
National Provider Identifier
1851817860
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
293555 Issued in CA
Practice address
6308 Vista del Mar Apt a
Playa del Rey, CA 90293-7512
Phone
(404) 434-7774
NPI assigned
Aug 22, 2017
Last updated
Aug 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 293555 CA Primary

Addresses

Primary practice location

6308 Vista del Mar Apt a
Playa del Rey, CA 90293-7512

Mailing address

6308 Vista del Mar Apt a
Playa del Rey, CA 90293-7512
Phone (404) 434-7774

Other practice location 1

5601 De Soto Ave
Woodland Hills, CA 91367-6701
Phone (818) 719-2770

Other practice location 2

3415 S Sepulveda Blvd # 1148
Los Angeles, CA 90034-6060
Phone (310) 881-2728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200518000482 CA Practitioner - Physical Therapist in Private Practice 5294166765 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
293555CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
A Plus Care Therapy Inc Orthopedic Current Accepting new patients

Locations

12100 Wilshire Blvd
Ste 800
Los Angeles, CA 90025
Phone (310) 383-6610

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
A Plus Care LLCLos Angeles, CA, CCN 559777 Home health agency 5% Or Greater Direct Ownership Interest (50%)
General Partnership Interest (50%)
Corporate Officer
Corporate Director
Jul 30, 2018
Jul 30, 2019
Jul 30, 2018
Jul 30, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1851817860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 VISTA DEL MAR APT A",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902937512",
            "telephone_number": "404-434-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 VISTA DEL MAR APT A",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902937512",
            "telephone_number": "404-434-7774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5601 De Soto Ave",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913676701",
            "country_code": "US",
            "telephone_number": "818-719-2770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3415 S Sepulveda Blvd # 1148",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900346060",
            "country_code": "US",
            "telephone_number": "310-881-2728",
            "fax_number": "323-300-2036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DESIREE",
        "middle_name": "JANINE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "293555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Playa del Rey, CA

Sources for this page

Verify at the official NPI Registry.