Individual provider Active NPI

Tina Denise Williams, FNP

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1154659100
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
146549 Issued in TN
Practice address
3385 Airways Blvd Ste 304
Memphis, TN 38116-3841
Phone
(901) 746-8078
Fax
(901) 746-8943
NPI assigned
Dec 3, 2009
Last updated
May 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A810532 MS
Family Nurse Practitioner 363LF0000X 146549 TN Primary
Family Nurse Practitioner 363LF0000X 151209 TN

Addresses

Primary practice location

3385 Airways Blvd Ste 304
Memphis, TN 38116-3841

Mailing address

PO Box 161406
Memphis, TN 38186-1406
Phone (901) 746-8078

Other identifiers 2

IdentifierTypeStateIssuer
1528450MedicaidTN
Q022344MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100122000624 TN Practitioner - Nurse Practitioner 8527100908 Reassigns benefits to 2 organizations
Practice locations: Memphis, TN
I20140425000707 MS Practitioner - Nurse Practitioner 8527100908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3385 Airways Blvd
Suite 304
Memphis, TN 38116-3806
Phone (901) 746-8078

3385 Airways Blvd
Suite 304
Memphis, TN 38116-3841
Phone (901) 746-8018

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A810532MSMDFamily Nurse Practitioner
146549TNMDFamily Nurse Practitioner
151209TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Healthcare Community Care Associates Current Accepting new patients
Methodist Healthcare Community Care Associates CurrentSince Sep 20, 2012 Accepting new patients
Methodist Healthcare Community Care Associates CurrentSince Sep 20, 2012 Accepting new patients
Methodist Healthcare Community Care Associates CurrentSince Jan 22, 2014 Accepting new patients
Williams Comprehensive Healthcare Family CurrentSince Jul 5, 2016 Accepting new patients
Adult Primary Care of Memphis PC Past Accepting new patients

Locations

7235 Hacks Cross Rd
Olive Branch, MS 38654
Phone (662) 893-7878

8035 Club Pkwy
Cordova, TN 38016
Phone (901) 758-6035

1331 Union Ave
Ste 1240
Memphis, TN 38104
Phone (865) 525-1540

3385 Airways Blvd
Ste 304
Memphis, TN 38116
Phone (901) 746-8018

8071 Winchester Rd
Memphis, TN 38125
Phone (901) 367-9001

Interoperability endpoints

  • Direct secure messaging: wchc@williamscomprehensivehc.kareodirect.com

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 4

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": "1259798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1154659100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161406",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381861406",
            "telephone_number": "901-746-8078",
            "fax_number": "901-746-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 AIRWAYS BLVD STE 304",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381163841",
            "telephone_number": "901-746-8078",
            "fax_number": "901-746-8943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TINA",
        "middle_name": "DENISE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-03",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "A810532",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "146549",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "151209",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528450",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q022344",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.