Individual provider Active NPI

Renee Dusold Williams, FNP

  • Primary Care Nurse Practitioner
  • Clayton, NC
National Provider Identifier
1184831950
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
201361 Issued in NC
Practice address
236 Butternut LN
Clayton, NC 27520-5857
Phone
(919) 359-1011
Fax
(919) 359-9122
NPI assigned
May 17, 2007
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 201361 NC Primary

Addresses

Primary practice location

236 Butternut LN
Clayton, NC 27520-5857

Mailing address

PO Box 96860
Charlotte, NC 28296-6860
Phone (919) 359-1011

Other identifiers 1

IdentifierTypeStateIssuer
201361OtherNCSTATE FNP LICENSE NUMBER

Other names 1

  • Mrs. Renee Dusold Williams Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20140819000771 NC Practitioner - Nurse Practitioner 2163649914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Durham Medical Group PAGroup PAC ID 2365409588, 80 clinicians

Practice addresses (Care Compare)

236 Butternut LN
Clayton, NC 27520-5857
Phone (919) 359-1011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201361NCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Durham Medical Group PA CurrentSince Aug 1, 2018 Accepting new patients
Raleigh Durham Medical Group, PA Family Past Accepting new patients

Locations

97 Cornerstone Dr
Cary, NC 27519
Phone (919) 460-0993

236 Butternut Ln
Clayton, NC 27520
Phone (919) 359-1011

Interoperability endpoints

  • Direct secure messaging: reneewilliams@hfmpa.allscriptsdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1184831950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96860",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282966860",
            "telephone_number": "919-359-1011",
            "fax_number": "919-359-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 BUTTERNUT LN",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205857",
            "telephone_number": "919-359-1011",
            "fax_number": "919-359-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RENEE",
        "middle_name": "DUSOLD",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "201361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE FNP LICENSE NUMBER",
            "identifier": "201361",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "WILLIAMS",
            "middle_name": "DUSOLD",
            "prefix": "MRS.",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.