Individual provider Active NPI

Stephanie Williams, RN

  • Adult Health Nurse Practitioner
  • Warner Robins, GA
National Provider Identifier
1093206591
Registry record updated May 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN188972 Issued in GA
Practice address
940 Ga Highway 96
Warner Robins, GA 31088-2584
Phone
(478) 988-1222
Fax
(478) 988-8098
NPI assigned
May 21, 2018
Last updated
May 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN188972 GA Primary

Addresses

Primary practice location

940 Ga Highway 96
Warner Robins, GA 31088-2584

Mailing address

940 Ga Highway 96
Warner Robins, GA 31088-2584
Phone (478) 988-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20191008000139 GA Practitioner - Nurse Practitioner 1254662158 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN188972GAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
River Edge Behavioral Health Center CurrentSince Dec 1, 2020 Accepting new patients

Locations

175 Emery Hwy
Macon, GA 31217
Phone (478) 751-4446

7741 Roswell Rd
Sandy Springs, GA 30350
Phone (404) 612-2273

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1093206591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 GA HIGHWAY 96",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310882584",
            "telephone_number": "478-988-1222",
            "fax_number": "478-988-8098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 GA HIGHWAY 96",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310882584",
            "telephone_number": "478-988-1222",
            "fax_number": "478-988-8098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "STEPHANIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN188972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.