Individual provider Active NPI

Penney L Williams, FNP

  • Family Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1053542845
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13984 Issued in TN
Practice address
7460 Wolf River Blvd
Germantown, TN 38138-1760
Phone
(901) 763-0200
Fax
(901) 761-4002
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13984 TN Primary

Addresses

Primary practice location

7460 Wolf River Blvd
Germantown, TN 38138-1760

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other practice location 1

6799 Great Oaks Rd Ste 250
Memphis, TN 38138-2584
Phone (901) 821-8300

Other practice location 2

1211 Union Ave Ste 965
Memphis, TN 38104-6638
Phone (901) 435-8550

Other practice location 3

3950 New Covington Pike Ste 220
Memphis, TN 38128-2595
Phone (901) 763-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20101014000724 TN Practitioner - Nurse Practitioner 5799820932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1803 Union Ave
Suite 2
Memphis, TN 38104-3910
Phone (901) 722-3136

8071 Winchester Rd
Memphis, TN 38125-8206
Phone (901) 756-6056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13984TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Healthcare Community Care Associates Current Accepting new patients
Specialty Physician Group LLC Family CurrentSince Oct 24, 2022 Accepting new patients
Methodist Healthcare Community Care Associates CurrentSince Sep 19, 2016 Accepting new patients
Methodist Healthcare Community Care Associates CurrentSince Sep 19, 2016 Accepting new patients
Saint Francis Physician Network, LLC PastSince Feb 5, 2018 Accepting new patients
Adult Primary Care of Memphis PC Past Accepting new patients

Locations

8035 Club Pkwy
Cordova, TN 38016
Phone (901) 758-6035

7460 Wolf River Blvd
Ste 200
Germantown, TN 38138

7460 Wolf River Blvd
#200
Germantown, TN 38138

1211 Union Ave
Ste 965
Memphis, TN 38104
Phone (901) 435-8550

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

3950 New Covington Pike
Ste 220
Memphis, TN 38128
Phone (901) 516-0829

7460 Wolf River Blvd
Memphis, TN 38138
Phone (901) 516-6792

8071 Winchester Rd
Memphis, TN 38125
Phone (901) 367-9001

Interoperability endpoints

  • Direct secure messaging: pwilliams31897@mlh.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1053542845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7460 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381760",
            "telephone_number": "901-763-0200",
            "fax_number": "901-761-4002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6799 Great Oaks Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381382584",
            "country_code": "US",
            "telephone_number": "901-821-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1211 Union Ave Ste 965",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381046638",
            "country_code": "US",
            "telephone_number": "901-435-8550",
            "fax_number": "901-478-0781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3950 New Covington Pike Ste 220",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381282595",
            "country_code": "US",
            "telephone_number": "901-763-0200",
            "fax_number": "901-516-5370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PENNEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "13984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.