Vancas Deangelo Williams, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-12796 Issued in NC

Practice address

1601 Brenner Ave
Salisbury, NC 28144-2515

Phone

(047) 638-9000

NPI assigned

Jan 7, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  NC, Physician Assistant

  Medicare reassignment NPD
• Mel Leaman Free Clinic at Emory & Henry College, Inc.

  • Primary Care Clinic/Center
  • Marion, VA
  • NPI 1699831511
  NPD (past)

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1952062200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 BRENNER AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442515",
            "telephone_number": "951-261-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRENNER AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442515",
            "telephone_number": "047-638-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "VANCAS",
        "middle_name": "DEANGELO",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-07",
        "last_updated": "2024-04-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-12796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Clarice Williams, LPCA
• Robert Dean Williams, PA-C
• Sarah Williams, PT
• Tanya Gay Williams, DMD
• Timothy Rae Williams, BS
• Wanda Deal Williams, MED, LPC
• Aleisa Keels Wilson
• Alicia Wilson, LCSW
• Amy E Wilson, M.D.
• Dennis Norman Farmer Wilson, MD

• Medical Physician Assistant in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.