Williams Primary Care of Tri-Cities, LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

BC18066 Issued in TN

Legal business name

WILLIAMS PRIMARY CARE OF TRI-CITIES, LLC

Practice address

1901 Brookside Dr Ste 105
Kingsport, TN 37660-4617

Phone

(423) 384-2820

NPI assigned

Nov 29, 2017

Organization subpart

No

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

Authorized official

Name

Penny Williams-Cordeiro, NP

Title

Owner

Phone

(423) 384-2820

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511913600000",
    "number": "1053825075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 BROOKSIDE DR STE 105",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604617",
            "telephone_number": "423-384-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 BROOKSIDE DR STE 105",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604617",
            "telephone_number": "423-384-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMS PRIMARY CARE OF TRI-CITIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-29",
        "last_updated": "2017-11-29",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS-CORDEIRO",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-384-2820",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "BC18066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen N Wilhjelm
• Kaylee Marie Wilhoit, PHARMD
• Vickie Wilhoit, CPHT
• Amy E Wilkinson, PT
• William B Hutchins Jr DDS PC
• Angela Dawn Williams
• Freddie Maxine Williams, MD
• Georgia Jane Williams, FNP
• Jamie Frances Williams, BA
• Kelsey Danielle Williams

• Primary Care Nurse Practitioner in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Primary Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.