Eddie Williams

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

16414 W 760 Rd
Tahlequah, OK 74464-1675

Phone

(918) 708-9009

NPI assigned

Feb 22, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1861148553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16414 W 760 RD",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744641675",
            "telephone_number": "918-708-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16414 W 760 RD",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744641675",
            "telephone_number": "918-708-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "EDDIE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "GoHealth",
            "affiliation": "N",
            "address_1": "16414 W 760 Rd",
            "city": "Tahlequah",
            "state": "OK",
            "country_code": "US",
            "postal_code": "744641675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Allen Wilkerson, PHARM.D
• Jessica L Wilkie-Goodman
• Jennifer Cheyanne Wilkie, DO
• Leonard Wilkins, O.D.
• Dennis Avery Williams, DO
• Leslie Williams, CNM
• Mackenzie Williams
• Sally R Williams, LPC
• Skylar Williams, DO
• Wyatt Williams, O.D.

• Peer Specialist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.