Raven Shanise Williams, PA-C is a medicare enrolled "Physician Assistant" in Mound Bayou, Mississippi. She graduated from nursing school in 2020 and has 5 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Delta Health Center, Inc. and her current practice location is
702 W. M.l.k. Jr Dr., Mound Bayou, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(662) 741-2151.
Raven Shanise Williams is licensed to practice in Mississippi (license number PA00656) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1528624160.
Provider's Profile
| Full Name | Raven Shanise Williams |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 5 Years |
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| Location | 702 W. M.l.k. Jr Dr., Mound Bayou, Mississippi |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Raven Shanise Williams graduated from nursing school in 2020
NPI Data:
- NPI Number: 1528624160
- Provider Enumeration Date: 05/18/2019
- Last Update Date: 05/20/2025
Medicare PECOS Information:
- PECOS PAC ID: 4183035553
- Enrollment ID: I20220906003174
Medical Identifiers
Medical identifiers for Raven Shanise Williams such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1528624160 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 6260 (Tennessee) | Secondary |
| 363A00000X | Physician Assistant | 8040 (Arizona) | Secondary |
| 363A00000X | Physician Assistant | PA00656 (Mississippi) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Delta Health Center, Inc. | 6608783295 | 18 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Raven Shanise Williams is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Raven Shanise Williams, PA-C
702 Martin Luther King St,
Mound Bayou, MS 38762-9314
Ph: (662) 741-8800 | Raven Shanise Williams, PA-C
702 W. M.l.k. Jr Dr.,
Mound Bayou, MS 38762
Ph: (662) 741-2151 |
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