Derek Lee Scott Williams, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2021013081 Issued in MO

Practice address

3233 E Sunshine St Ste 100
Springfield, MO 65804-2106

Phone

(417) 812-8149

NPI assigned

Mar 18, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Southern Missouri Ambulatory Services LLCGroup PAC ID 5193089621, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Southern Missouri Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springfield, MO
  • NPI 1871094052
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657

  Family

  NPD
• Lincoln County Hospital

  • Critical Access Hospital
  • Lincoln, KS
  • NPI 1942265327
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1043896301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3233 E SUNSHINE ST STE 100",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042106",
            "telephone_number": "417-812-8149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3233 E SUNSHINE ST STE 100",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042106",
            "telephone_number": "417-812-8149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1308 N Glenstone Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658022130",
            "country_code": "US",
            "telephone_number": "417-832-1117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DEREK",
        "middle_name": "LEE SCOTT",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021013081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487001517",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Curtice E Williams III, CRNA
• Daniel Mark Williams, M.D.
• Darrell Williams, LPC
• David Michael Williams, NP
• Debra Lynne Williams, O.D.
• Drusilla Williams
• Jeffrey Williams, PHARM D
• Jennifer Ann Williams
• John W Williams IV, MD
• Labryon Williams, M.A

• Family Nurse Practitioner in Springfield, MO
• Providers in Springfield, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.