1306885777 NPI number — DANIELLE E WILLIAMS D.O.T.

Table of content: DANIELLE E WILLIAMS D.O.T. (NPI 1306885777)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306885777 NPI number — DANIELLE E WILLIAMS D.O.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WILLIAMS
Provider First Name:
DANIELLE
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KOSKI
Provider Other First Name:
DANIELLE
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.T.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306885777
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1115 BOULDERS PKWY
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
NORTH CHESTERFIELD
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23225-4067
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-560-5595
Provider Business Mailing Address Fax Number:
804-560-9029

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 JOHNSTON WILLIS DR
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23235-4765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-379-3840
Provider Business Practice Location Address Fax Number:
804-379-9567
Provider Enumeration Date:
06/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  0119004282 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 540885859 . This is a "FOCUS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 540885859 . This is a "COMPMANAGEMENT" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7083811 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 194769 . This is a "ANTHEM CHIP OT" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010274052 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 540885859 . This is a "MULTIPLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0472640003 . This is a "DMERC-JOHNSTON-WILLIS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1387429 . This is a "AETNA HMO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 194770 . This is a "ANTHEM-JOHNSTON-WILLIS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1577 . This is a "SH CARENET" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 98999 . This is a "OPTIMA HEALTH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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