Active NPI
Mara Susan Williams
- Adult Health Nurse Practitioner
- Napa, CA
National Provider Identifier
1861544249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 345522
- Practice address
- 3417 Valle Verde Dr
Napa, CA 94558-2414 - Phone
- (707) 255-4172
- Fax
- (707) 255-2605
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 345522 | CA | Primary |
Addresses
Primary practice location
3417 Valle Verde Dr
Napa, CA 94558-2414
Mailing address
19337 Orange Ave
Sonoma, CA 95476-6215
Phone (707) 996-6219
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15902 | Other | CA | NP FURNISHING NUMBER |
| 15902 | Other | CA | NP CERTIFICATE NUMBER |
| 345522 | Other | CA | RN LICENSE |
Other names 1
- Martha Block, Donnelly, Palmer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2016 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15902 | CA | MD | Acupuncturist |
| 345522 | CA | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1861544249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19337 ORANGE AVE",
"city": "SONOMA",
"state": "CA",
"postal_code": "954766215",
"telephone_number": "707-996-6219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3417 VALLE VERDE DR",
"city": "NAPA",
"state": "CA",
"postal_code": "945582414",
"telephone_number": "707-255-4172",
"fax_number": "707-255-2605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "MARA",
"middle_name": "SUSAN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CA",
"license": "345522",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NP FURNISHING NUMBER",
"identifier": "15902",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NP CERTIFICATE NUMBER",
"identifier": "15902",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "345522",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARTHA",
"last_name": "BLOCK, DONNELLY, PALMER",
"credential": "ANP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Napa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.