Individual provider Active NPI

Lisa E. Williams, L.P.N.

  • Licensed Practical Nurse
  • Newark, NY
National Provider Identifier
1922377902
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
267410-1 Issued in NY
Practice address
701 Peirson Ave.
Newark, NY 14513
Phone
(315) 332-3230
NPI assigned
Dec 21, 2011
Last updated
Dec 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 267410-1 NY Primary

Addresses

Primary practice location

701 Peirson Ave.
Newark, NY 14513

Mailing address

1993 Clyde Marengo Rd
Clyde, NY 14433-9516
Phone (315) 332-3349

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
267410-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1922377902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1993 CLYDE MARENGO RD",
            "city": "CLYDE",
            "state": "NY",
            "postal_code": "144339516",
            "telephone_number": "315-332-3349",
            "fax_number": "315-332-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PEIRSON AVE.",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "14513",
            "telephone_number": "315-332-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LISA",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "267410-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.