Individual provider Active NPI

Marilyn Sue Williams, RN

  • Registered Nurse
  • Waverly, OH
National Provider Identifier
1932394350
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN250003 Issued in OH
Practice address
207 1St Ave
Waverly, OH 45690-1104
Phone
(740) 947-7159
NPI assigned
Sep 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN250003 OH Primary

Addresses

Primary practice location

207 1St Ave
Waverly, OH 45690-1104

Mailing address

207 1St Ave
Waverly, OH 45690-1104
Phone (740) 947-7159

Other identifiers 1

IdentifierTypeStateIssuer
2604757MedicaidOH

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
RN250003OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1932394350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 1ST AVE",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901104",
            "telephone_number": "740-947-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 1ST AVE",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901104",
            "telephone_number": "740-947-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARILYN",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN250003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2604757",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.