Individual provider Active NPI

Jennifer Williams, NP

  • Family Nurse Practitioner
  • Vicksburg, MS
National Provider Identifier
1124789508
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
905092 Issued in MS
Practice address
2080 S Frontage Rd
Vicksburg, MS 39180-5328
Phone
(601) 654-7070
NPI assigned
Jan 6, 2022
Last updated
Dec 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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 905092 MS Primary

Addresses

Primary practice location

2080 S Frontage Rd
Vicksburg, MS 39180-5328

Mailing address

1262 Kimbell Rd
Terry, MS 39170-9438
Phone (601) 218-7141

Other practice location 1

1262 Kimbell Rd
Terry, MS 39170-9438
Phone (601) 218-7141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20230510003475 MS Practitioner - Nurse Practitioner 0648636928 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Management Specialists LLCGroup PAC ID 5193056364, 157 clinicians
Wound Care Associates LLCGroup PAC ID 0840314548, 117 clinicians

Practice addresses (Care Compare)

1190 N State St
Jackson, MS 39202-2413
Phone (769) 243-6141

2080 S Frontage Rd
Suite 109
Vicksburg, MS 39180-5882
Phone (601) 636-6233

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Plus Limited Liability Company CurrentSince Jul 26, 2025 Accepting new patients
Wound Care Associates LLC CurrentSince Dec 8, 2025 Accepting new patients
Hands to Healing,LLC CurrentSince Feb 10, 2023 Accepting new patients
Wound Management Specialists, LLC CurrentSince Jul 15, 2024 Accepting new patients
Corner Clinic Urgent Care LLC Family PastSince Feb 10, 2023 Accepting new patients
Winston Medical Clinic LLC PastSince Jul 15, 2024 Accepting new patients

Locations

16065 Lamonte Dr
Hammond, LA 70403
Phone (985) 956-7771

2781 C T Switzer SR Dr
Ste 100
Biloxi, MS 39531
Phone (228) 207-8632

778 Liberty Rd
Flowood, MS 39232
Phone (601) 326-1794

1190 N State St
Ste 2A
Jackson, MS 39202
Phone (601) 292-4292

3823 Highway 80 E
Ste 200
Pearl, MS 39208
Phone (769) 223-3261

431 W Race St
Rolling Fork, MS 39159
Phone (662) 795-0440

2080 S Frontage Rd
Ste 109
Vicksburg, MS 39180
Phone (601) 636-6233

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16354/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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 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": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1124789508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1262 KIMBELL RD",
            "city": "TERRY",
            "state": "MS",
            "postal_code": "391709438",
            "telephone_number": "601-218-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 S FRONTAGE RD",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391805328",
            "telephone_number": "601-654-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1262 Kimbell Rd",
            "address_purpose": "LOCATION",
            "city": "Terry",
            "state": "MS",
            "postal_code": "391709438",
            "country_code": "US",
            "telephone_number": "601-218-7141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

Verify at the official NPI Registry.