NPIMap

Individual provider Active NPI

Schaquwa Renia Williams, FNP-C

  • Family Nurse Practitioner
  • Wilmer, AL
National Provider Identifier
1093417883
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-131954 Issued in AL
Practice address
5220 Danita Cir W
Wilmer, AL 36587-9111
Phone
(251) 402-3393
NPI assigned
Mar 17, 2023
Last updated
Mar 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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 1-131954 AL Primary

Addresses

Primary practice location

5220 Danita Cir W
Wilmer, AL 36587-9111

Mailing address

5220 Danita Cir W
Wilmer, AL 36587-9111
Phone (251) 402-3393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230426000612 AL Practitioner - Nurse Practitioner 8820453889 Reassigns benefits to 2 organizations
I20240916000799 MS Practitioner - Nurse Practitioner 8820453889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-5201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-131954ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Hospital and Clinic, Inc. Current Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Jackson Hospital & Clinic, Inc. CurrentSince Mar 28, 2024 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Aug 19, 2024 Accepting new patients
Jackson Hospital and Clinic, Inc. CurrentSince Mar 28, 2024 Accepting new patients
Signify Health, LLC CurrentSince Jan 24, 2023 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Aug 19, 2024 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 314-5700

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 8

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 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1093417883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 DANITA CIR W",
            "city": "WILMER",
            "state": "AL",
            "postal_code": "365879111",
            "telephone_number": "251-402-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 DANITA CIR W",
            "city": "WILMER",
            "state": "AL",
            "postal_code": "365879111",
            "telephone_number": "251-402-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SCHAQUWA",
        "middle_name": "RENIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-131954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmer, AL

Sources for this page

Verify at the official NPI Registry.