Individual provider Active NPI

Kevin Scott Williams, APRN, RN, EMT-P

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1083754048
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11000839 Issued in FL
Practice address
12902 Usf Magnolia Dr RM 1072
Tampa, FL 33612
Phone
(813) 745-2800
Fax
(813) 449-8563
NPI assigned
Feb 7, 2007
Last updated
Jan 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Paramedic 146L00000X PMD205169 FL
Basic Emergency Medical Technician 146N00000X EMT88434 FL
Critical Care Medicine Registered Nurse 163WC0200X RN9218022 FL
Nurse Practitioner 363L00000X 11000839 FL Primary

Addresses

Primary practice location

12902 Usf Magnolia Dr RM 1072
Tampa, FL 33612

Mailing address

2995 Drew St
Clearwater, FL 33759-3012
Phone (727) 315-7496

Other practice location 1

409 Bayshore Blvd
Tampa, FL 33606-2707
Phone (813) 253-2640 ext. 1135

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kevin.WilliamsAPRN@direct.mybaycare.org Health Information Exchange (HIE) St. Joseph's Hospital, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220405003002 FL Practitioner - Nurse Practitioner 7012303704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Joseph's Hospital, Inc.Group PAC ID 1658274287, shared by 5 NPIs, 9 clinicians

Practice addresses (Care Compare)

2123 W MLK Blvd
Suite 201
Tampa, FL 33607-6545
Phone (813) 870-4460

4600 N Habana Ave
Suite 15
Tampa, FL 33614-7123
Phone (813) 870-4460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Emergency Medical Technician - Paramedic, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
PMD205169FLMDParamedic
EMT88434FLMDBasic Emergency Medical Technician
RN9218022FLMDCritical Care Medicine Registered Nurse
11000839FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Hospital, Inc. CurrentSince Apr 1, 2022 Accepting new patients
St Joseph's Hospital Inc CurrentSince Apr 1, 2022 Accepting new patients
St. Joseph's Hospital, Inc. CurrentSince Apr 1, 2022 Accepting new patients
St. Joseph's Hospital, Inc. Past Accepting new patients

Locations

2995 Drew St
Bldg 2ND
Clearwater, FL 33759

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

3050 1st Ave S
St Petersburg, FL 33712
Phone (727) 209-3500

2123 W Mlk Blvd
Ste 201
Tampa, FL 33607
Phone (813) 870-4460

4600 N Habana Ave
Ste 15
Tampa, FL 33614
Phone (813) 870-4460

Interoperability endpoints

  • Direct secure messaging: kevin.williamsaprn@direct.mybaycare.org

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1083754048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-315-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR RM 1072",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33612",
            "telephone_number": "813-745-2800",
            "fax_number": "813-449-8563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "409 Bayshore Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336062707",
            "country_code": "US",
            "telephone_number": "813-253-2640 x1135",
            "fax_number": "813-349-6512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KEVIN",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "APRN, RN, EMT-P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "FL",
            "license": "PMD205169",
            "primary": false
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "FL",
            "license": "EMT88434",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "RN9218022",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11000839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kevin.WilliamsAPRN@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "St. Joseph's Hospital, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12902 Usf Magnolia Dr Rm 1072",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.