Individual provider Active NPI

Antoinette Cecile Williams

  • Non-emergency Medical Transport (VAN)
  • Orange Park, FL
National Provider Identifier
1861784381
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
W452003637410 Issued in FL
Practice address
3752 Briar LN
Orange Park, FL 32065-2517
Phone
(805) 369-4935
NPI assigned
May 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X W452003637410 FL Primary

Addresses

Primary practice location

3752 Briar LN
Orange Park, FL 32065-2517

Mailing address

3752 Briar LN
Orange Park, FL 32065-2517
Phone (805) 369-4935

Other identifiers 1

IdentifierTypeStateIssuer
6389MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
W452003637410FLMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
Bronze Owl LLC Non-Emergency Medical Transport (Van) Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1861784381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3752 BRIAR LN",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652517",
            "telephone_number": "805-369-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3752 BRIAR LN",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652517",
            "telephone_number": "805-369-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANTOINETTE",
        "middle_name": "CECILE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-03",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "FL",
            "license": "W452003637410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6389",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.