Individual provider Active NPI

Sharde Williams, RN

  • Registered Nurse
  • Clinton, MS
National Provider Identifier
1902303019
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
893427 Issued in MS
Practice address
322 Highway 80 E Ste D
Clinton, MS 39056-4726
Phone
(601) 586-9274
NPI assigned
Apr 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 893427 MS Primary

Addresses

Primary practice location

322 Highway 80 E Ste D
Clinton, MS 39056-4726

Mailing address

1526 David Dr
Jackson, MS 39209-5711
Phone (601) 899-2012

Other practice location 1

5888 Ridgewood Rd
Jackson, MS 39211-2644
Phone (601) 586-9274

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
893427MSMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1902303019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 DAVID DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392095711",
            "telephone_number": "601-899-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 HIGHWAY 80 E STE D",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564726",
            "telephone_number": "601-586-9274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5888 Ridgewood Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392112644",
            "country_code": "US",
            "telephone_number": "601-586-9274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHARDE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2021-06-17",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "893427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.