Active NPI
Sherry L. Williams, D.P.M.
- Podiatrist
- North Bend, OR
National Provider Identifier
1982698080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- DP00365
- Practice address
- 3229 Broadway St
Suite D
North Bend, OR 97459-2203 - Phone
- (541) 756-1190
- Fax
- (541) 756-1199
- NPI assigned
- Sep 2, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E4460 | CA | |
| Podiatrist | 213E00000X | DP00365 | OR | Primary |
Addresses
Primary practice location
3229 Broadway St
Suite D
North Bend, OR 97459-2203
Mailing address
3229 Broadway St
Suite D
North Bend, OR 97459-2203
Phone (541) 756-1190
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E4460 | CA | MD | Podiatrist |
| DP00365 | OR | MD | Podiatrist |
| 4460 | CA | MD | Speech-Language Assistant |
Interoperability endpoints
- sherry.williams.1@7006.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298332800000",
"number": "1982698080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3229 BROADWAY ST",
"address_2": "SUITE D",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974592203",
"telephone_number": "541-756-1190",
"fax_number": "541-756-1199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3229 BROADWAY ST",
"address_2": "SUITE D",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974592203",
"telephone_number": "541-756-1190",
"fax_number": "541-756-1199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "SHERRY",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-02",
"last_updated": "2011-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E4460",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "OR",
"license": "DP00365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.