Active NPI
Jacquelin Michele Williams, FNP-C
- Family Nurse Practitioner
- Salisbury, NC
National Provider Identifier
1902376296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 189227
- Practice address
- 115 W Liberty St
Salisbury, NC 28144-4332 - Phone
- (980) 230-0902
- NPI assigned
- Nov 28, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 189227 | NC | |
| Family Nurse Practitioner | 363LF0000X | 5011208 | NC | |
| Family Nurse Practitioner | 363LF0000X | 189227 | NC | Primary |
Addresses
Primary practice location
115 W Liberty St
Salisbury, NC 28144-4332
Mailing address
4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (800) 828-0898
Other practice location 1
920 Church St N
Concord, NC 28025-2927
Phone (980) 230-0902
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jwilliams45672@direct.novanthealth.org |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 189227 | NC | MD | Family Nurse Practitioner |
Interoperability endpoints
- jwilliams45672@direct.novanthealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1902376296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4535 DRESSLER RD NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447182545",
"telephone_number": "800-828-0898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 W LIBERTY ST",
"city": "SALISBURY",
"state": "NC",
"postal_code": "281444332",
"telephone_number": "980-230-0902"
}
],
"practiceLocations": [
{
"address_1": "920 Church St N",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "NC",
"postal_code": "280252927",
"country_code": "US",
"telephone_number": "980-230-0902",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JACQUELIN",
"middle_name": "MICHELE",
"name_prefix": "Mrs.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-28",
"last_updated": "2020-10-26",
"certification_date": "2020-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "189227",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5011208",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "189227",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jwilliams45672@direct.novanthealth.org",
"affiliation": "N",
"address_1": "920 Church St N",
"city": "Concord",
"state": "NC",
"country_code": "US",
"postal_code": "280252927",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Salisbury, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.