Individual provider Active NPI

Amber Elaine Williams, FNP

  • Family Nurse Practitioner
  • Pomona, CA
National Provider Identifier
1144072711
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95027785 Issued in CA
Practice address
255 E Bonita Ave Ste 100
Pomona, CA 91767-1923
Phone
(909) 643-2980
NPI assigned
Apr 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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 95027785 CA Primary

Addresses

Primary practice location

255 E Bonita Ave Ste 100
Pomona, CA 91767-1923

Mailing address

5908 Cedarglen Dr
Azusa, CA 91702-4625
Phone (909) 638-4264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240614002573 CA Practitioner - Nurse Practitioner 2961945282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16465 Sierra Lakes Pkwy
Fontana, CA 92336-1242
Phone (909) 434-1150

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Urgent Care Group, Inc CurrentSince May 1, 2024 Accepting new patients
Mountain View Urgent Care Group, Inc CurrentSince May 1, 2024 Accepting new patients
Mountain View Emergency Physicians Medical Group, Inc. CurrentSince May 1, 2024 Accepting new patients
Cucamonga Valley Medical Group, Inc. PastSince Apr 9, 2024 Accepting new patients

Locations

12442 Limonite Ave
Unit 102
Eastvale, CA 91752
Phone (951) 393-3000

16465 Sierra Lakes Pkwy
Ste 100
Fontana, CA 92336
Phone (909) 434-1150

255 E Bonita Ave
Ste 100
Pomona, CA 91767
Phone (909) 429-2864

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18095/brand/2/csg/1/fhir/r4

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 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": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1144072711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5908 CEDARGLEN DR",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917024625",
            "telephone_number": "909-638-4264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E BONITA AVE STE 100",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671923",
            "telephone_number": "909-643-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AMBER",
        "middle_name": "ELAINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.