1710299979 NPI number — VIRGINIA ELIZABETH WILLIAMS M.ED, ATC-L

NPI Number: 1710299979
Health Care Provider/Practitioner: VIRGINIA ELIZABETH WILLIAMS M.ED, ATC-L

NPI Number : 1710299979 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710299979",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WILLIAMS",
    "FirstName": "VIRGINIA",
    "MiddleName": "ELIZABETH",
    "NamePrefix": "MISS",
    "NameSuffix": null,
    "Credential": "M.ED, ATC-L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "115 S SAINT MARYS ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RALEIGH",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27603-1699",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "180-036-2090",
    "MailingAddressFaxNumber": "186-643-4509",
    "FirstLinePracticeLocationAddress": "115 S SAINT MARYS ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RALEIGH",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "27603-1699",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "180-036-2090",
    "PracticeLocationAddressFaxNumber": "186-643-4509",
    "EnumerationDate": "07/05/2010",
    "LastUpdateDate": "07/05/2010",
    "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": "1430",
        "LicenseNumberStateCode": "NC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}