Tara S Williams, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP112022 Issued in TX

Practice address

3200 Southwest Fwy Ste 2100
Houston, TX 77027-7525

Phone

(833) 208-7770

Fax

(833) 464-3584

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 1

• Tara Shephard Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tara.williams.1@27760.direct.athenahealth.com

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.

• Children'S Health PM Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • McKinney, TX
  • NPI 1275013955
  NPD (past)
• Stonebridge Pediatrics

  • Pediatrics Physician
  • McKinney, TX
  • NPI 1760677538
  NPD (past)
• Form Health Associates Ma, P.C.

  • Endocrinology, Diabetes & Metabolism Physician
  • Boston, MA
  • NPI 1386260594
  NPD (past)
• Imagine Pediatrics of Florida LLC

  • Pediatrics Physician
  • Tampa, FL
  • NPI 1104542232
  NPD (past)
• PM Pediatrics of Florida

  • Urgent Care Clinic/Center
  • Coral Springs, FL
  • NPI 1174125561

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1174739239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 PIERSALL DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750723406",
            "telephone_number": "972-679-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SOUTHWEST FWY STE 2100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277525",
            "telephone_number": "833-208-7770",
            "fax_number": "833-464-3584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Athens Way Ste 240",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372281311",
            "country_code": "US",
            "telephone_number": "833-208-7770",
            "fax_number": "833-464-3584",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3109 W Dr Martin Luther King Jr Blvd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076208",
            "country_code": "US",
            "telephone_number": "833-208-7770",
            "fax_number": "833-450-0456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TARA",
        "middle_name": "S",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "NP500014523",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11024750",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024190458",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "R0069453",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383654-01",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP112022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119979700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174739239",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tara.williams.1@27760.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Other",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Direct Messaging",
            "address_1": "3200 Southwest Fwy Ste 2100",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770277525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "SHEPHARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Surely Nae McDade Williams
• Susan Williams, MD
• Tamika Tiffany Williams, PA-C
• Tammara Williams, BT
• Tanya Evette Williams, B.S.N.
• Tarkitha Williams
• Tarynne Williams
• Tashiba Q. Williams, NP
• Taylor Williams, DC
• Tejumade Kehinde Williams, DO

• Pediatric Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.