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1518486810 NPI number — SHIRA BREY WILLIAMS MS, ATC, LAT, ITAT

NPI Number: 1518486810
Health Care Provider/Practitioner: SHIRA BREY WILLIAMS MS, ATC, LAT, ITAT

Information about “1518486810” NPI (SHIRA BREY WILLIAMS MS, ATC, LAT, ITAT) exists in 1518486810 in HTML format HTML  |  1518486810 in plain Text format TXT  |  1518486810 in PDF (Portable Document Format) PDF  |  1518486810 in an XML format XML  formats.

NPI Number : 1518486810 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1518486810",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WILLIAMS",
    "FirstName": "SHIRA",
    "MiddleName": "BREY",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "MS, ATC, LAT, ITAT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1000 UNIVERSITY CENTER LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAWRENCEVILLE",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30043-7409",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "678-407-5000",
    "MailingAddressFaxNumber": "678-407-5671",
    "FirstLinePracticeLocationAddress": "1030 COLLINS HILL RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAWRENCEVILLE",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30043",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "678-407-5671",
    "PracticeLocationAddressFaxNumber": "678-407-5671",
    "EnumerationDate": "09/18/2017",
    "LastUpdateDate": "09/18/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2255A2300X",
        "TaxonomyName": "Athletic Trainer",
        "LicenseNumber": "20000122004",
        "LicenseNumberStateCode": "GA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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