Individual provider Active NPI

Edna Danielle Williamson, PA-C

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1912138959
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC030 Issued in KY
Practice address
3205 Summit Square PL Ste 100
Lexington, KY 40509-2650
Phone
(859) 335-9041
Fax
(859) 335-9072
NPI assigned
Aug 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC030 KY Primary

Addresses

Primary practice location

3205 Summit Square PL Ste 100
Lexington, KY 40509-2650

Mailing address

3205 Summit Square PL Ste 100
Lexington, KY 40509-2650
Phone (859) 335-9041

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TC030KYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky Hospital Past Accepting new patients
Marshall Emergency Services Associates, PLLC Physician Assistant Past Accepting new patients

Organizations & group practices 2

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": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1912138959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 SUMMIT SQUARE PL STE 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092650",
            "telephone_number": "859-335-9041",
            "fax_number": "859-335-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 SUMMIT SQUARE PL STE 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092650",
            "telephone_number": "859-335-9041",
            "fax_number": "859-335-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "EDNA",
        "middle_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.