Individual provider Active NPI

Courtney Brooke Williams, MSN, FNP

  • Family Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1104391689
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN245144 Issued in GA
Practice address
712 E 70TH St
Savannah, GA 31405-4811
Phone
(912) 352-8974
NPI assigned
Oct 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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 RN245144 GA Primary

Addresses

Primary practice location

712 E 70TH St
Savannah, GA 31405-4811

Mailing address

102 Pasofina Dr
Guyton, GA 31312-5769
Phone (304) 841-1798

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
I20181127002713 GA Practitioner - Nurse Practitioner 2769726082 Reassigns benefits to 1 organization

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
Pritzker Dermatology, P.C.Group PAC ID 9133100852, 3 clinicians

Practice addresses (Care Compare)

712 E 70TH St
Savannah, GA 31405-4811
Phone (912) 352-8974

Hospital & facility affiliations

  • St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN245144GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pritzker Dermatology, P.C. CurrentSince Oct 15, 2018 Accepting new patients

Locations

712 E 70th St
Savannah, GA 31405
Phone (912) 352-8974

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GHCBCA
  • FHIR API: https://fhir4.healow.com/fhir/r4/GHCBCA/Endpoint/GHCBCA

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1104391689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PASOFINA DR",
            "city": "GUYTON",
            "state": "GA",
            "postal_code": "313125769",
            "telephone_number": "304-841-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 E 70TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054811",
            "telephone_number": "912-352-8974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "COURTNEY",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN245144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.