Organization Active NPI

Mace Anthony Williamson Foundation

  • Doula
  • St Petersburg, FL
National Provider Identifier
1972257467
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Legal business name
MACE ANTHONY WILLIAMSON FOUNDATION
Practice address
111 2ND Ave NE Ste 360
St Petersburg, FL 33701-3580
Phone
(727) 253-7729
NPI assigned
Feb 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Maiye Ta'Kiyah Waller, DOULANPI 1588452460
Title
Executive Director, Founder
Phone
(727) 253-7729

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DoulaGroup: 193200000X MULTI-SPECIALTY GROUP 374J00000X Primary

Addresses

Primary practice location

111 2ND Ave NE Ste 360
St Petersburg, FL 33701-3580

Mailing address

111 2ND Ave NE Ste 360
St Petersburg, FL 33701-3580
Phone (727) 253-7729

Other names 1

  • The Mace Anthony Williamson Foundation Other name

National Provider Directory

National Provider Directory

Locations

111 2nd Ave NE
Ste 360
St Petersburg, FL 33701
Phone (727) 253-7729

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1972257467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE STE 360",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013580",
            "telephone_number": "727-253-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE STE 360",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013580",
            "telephone_number": "727-253-7729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACE ANTHONY WILLIAMSON FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-04",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "MAIYE",
        "authorized_official_middle_name": "TA'KIYAH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, FOUNDER",
        "authorized_official_telephone_number": "727-253-7729",
        "authorized_official_credential": "DOULA"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Mace Anthony Williamson Foundation",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Mace Anthony Williamson Foundation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.