Justin Banks Williams, OTD, MS, OTR/L, PM

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

3679 Issued in SC

Practice address

10 Fountainview Ter
Greenville, SC 29607-4033

Phone

(864) 233-6367

NPI assigned

Jun 23, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1902117096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SPRINGCREST CT",
            "address_2": "GENESIS REHAB SERVICES",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074034",
            "telephone_number": "864-528-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FOUNTAINVIEW TER",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074033",
            "telephone_number": "864-233-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JUSTIN",
        "middle_name": "BANKS",
        "name_prefix": "Dr.",
        "credential": "OTD, MS, OTR/L, PM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-23",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "SC",
            "license": "3679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josef Michael Williams, D.O.
• Josiah Grant Williams, CRNP
• Judd Trent Williams, DO
• Julian B Williams, LPC
• Julie L Williams, COTA
• Kandelyn Bridgette Williams
• Karen Renee Williams, LPN
• Kathryn Williams
• Khadijah Williams
• Kimberly Jean Williams, D.C.

• Gerontology Occupational Therapist in Greenville, SC
• Providers in Greenville, SC by specialty
• Gerontology Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.