Darthvader Devon Williamson, RSA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Practice address

2986 Kate Bond Rd
Bartlett, TN 38133-4003

Phone

(901) 820-7468

NPI assigned

Apr 14, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555200000000",
    "number": "1972166114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13560 HIGHWAY 196",
            "city": "EADS",
            "state": "TN",
            "postal_code": "380283606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2986 KATE BOND RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334003",
            "telephone_number": "901-820-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "DARTHVADER",
        "middle_name": "DEVON",
        "credential": "RSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2019-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TN",
            "license": "MAS0000000047",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff Williams, DDS
• Latonya Yvonne Williams
• Linda Fay Williams, APN
• Sharlene Williams, M.S. / LPC
• Tynisha Williams, RN
• Erica Renee Williamson, LCSW
• Wilson and Dowling Primary Care, PLLC
• Joseph Wilson-Webster
• Elizabeth Bridget Windley, LCSW
• Jamie Lynn Wise, FNP-BC

• Surgical Assistant in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Surgical Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2019; 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.