Active NPI
Angela Faye Woodley-Williams, RN, NP-C
- Primary Care Nurse Practitioner
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 4704157534
- Practice address
- 11260 E Jefferson Ave
Detroit, MI 48214-3320 - Phone
- (313) 749-0148
- NPI assigned
- Aug 20, 2009
- Last updated
- May 18, 2020
- 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 |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 4704157534 | MI | Primary |
Addresses
Primary practice location
11260 E Jefferson Ave
Detroit, MI 48214-3320
Mailing address
30 W Monroe St Ste 1200
Chicago, IL 60603-2420
Phone (312) 733-9730
Other practice location 1
7430 2nd Ave
Suite 210
Detroit, MI 48202-2739
Phone (313) 748-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11260 E Jefferson Ave
Jefferson Village Clinic
Detroit, MI 48214-3320
Phone (313) 749-0148
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704157534 | MI | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osh-Mi Physicians Group PC | Current | Accepting new patients | |
| Osh Mi Physicians Group, PC | Current | Accepting new patients | |
| Osh-Mi Physicians Group PC | Primary Care | Past | Accepting new patients |
Locations
30 W Monroe St
Ste 1200
Chicago, IL 60603
Phone (773) 609-1758
11260 E Jefferson Ave
Detroit, MI 48214
Phone (313) 306-5494
Interoperability endpoints
- angela.woodlywilliams@oakstreethealth.gwaydirect.com
Organizations & group practices 3
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.
-
- Primary Care Clinic/Center
- Detroit, MI
- NPI 1700236478
-
- Primary Care Clinic/Center
- Memphis, TN
- NPI 1720635790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589760000000",
"number": "1861624058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 W MONROE ST STE 1200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606032420",
"telephone_number": "312-733-9730",
"fax_number": "773-866-8014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11260 E JEFFERSON AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482143320",
"telephone_number": "313-749-0148"
}
],
"practiceLocations": [
{
"address_1": "7430 2nd Ave",
"address_2": "Suite 210",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482022739",
"country_code": "US",
"telephone_number": "313-748-4200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOODLEY-WILLIAMS",
"first_name": "ANGELA",
"middle_name": "FAYE",
"name_prefix": "Ms.",
"credential": "RN, NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-20",
"last_updated": "2020-05-18",
"certification_date": "2020-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "MI",
"license": "4704157534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.