Raven Shanise Williams, PA-C is a medicare enrolled "Physician Assistant" in West Memphis, Arkansas. Her current practice location is
900 N 7th St, West Memphis, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(870) 293-0594.
Raven Shanise Williams is licensed to practice in Arkansas (license number PA-1504) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. 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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| Location | 900 N 7th St, West Memphis, Arkansas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1528624160
- Provider Enumeration Date: 05/18/2019
- Last Update Date: 06/24/2026
Medicare PECOS Information:
- PECOS PAC ID: 4183035553
- Enrollment ID: I20201117000573
Medical Identifiers
Medical identifiers for Raven Shanise Williams such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1528624160 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 8040 (Arizona) | Secondary |
| 363A00000X | Physician Assistant | PA00656 (Mississippi) | Secondary |
| 363A00000X | Physician Assistant | PA-1504 (Arkansas) | Primary |
| 363A00000X | Physician Assistant | 6260 (Tennessee) | Secondary |
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 |
|---|
Raven Shanise Williams, PA-C
900 N 7th St,
West Memphis, AR 72301-2001
Ph: (870) 735-3842 | Raven Shanise Williams, PA-C
900 N 7th St,
West Memphis, AR 72301-2001
Ph: (870) 293-0594 |
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