Individual provider Active NPI

Elizabeth Ann Williams, FNP, PMHNP

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1205844537
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R835129 Issued in MS
Practice address
1200 N State St Ste 420
Jackson, MS 39202-2027
Phone
(601) 355-3353
Fax
(601) 355-3365
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X R835129 MS
Family Nurse Practitioner 363LF0000X R835129 MS Primary

Addresses

Primary practice location

1200 N State St Ste 420
Jackson, MS 39202-2027

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401

Other practice location 1

2500 N State St
Department of Neurology
Jackson, MS 39216-4500
Phone (601) 984-6382

Other identifiers 2

IdentifierTypeStateIssuer
02326761MedicaidMS
P01653063OtherMSRAILROAD MEDICARE PTAN

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
I20051220000156 MS Practitioner - Nurse Practitioner 1153343132 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1151 N State St
Suite 404
Jackson, MS 39202-2457
Phone (601) 292-4261

1200 N State St
Jackson, MS 39202-2027

1225 N State St
Jackson, MS 39202-2064
Phone (601) 292-4261

401 Baptist Dr
Suite 104
Madison, MS 39110-2010
Phone (601) 973-1504

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R835129MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 1, 2012 Accepting new patients
Medical Foundation of Central Mississippi, Inc. CurrentSince Dec 12, 2021 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Aug 1, 2012 Accepting new patients
Mississippi Baptist Medical Center, Inc CurrentSince Dec 12, 2021 Accepting new patients
Mississippi Baptist Medical Center, Inc. Current Accepting new patients
Medical Foundation of Central Ms CurrentSince Dec 12, 2021 Accepting new patients
Mississippi Baptist Medical Center, Inc. CurrentSince Dec 12, 2021 Accepting new patients
Precise Psychopharmacology LLC Past Accepting new patients
Precise Clinical Neuroscience Specialists Past Accepting new patients

Locations

1815 Hospital Dr
Jackson, MS 39204
Phone (601) 815-4775

1190 N State St
Ste 301
Jackson, MS 39202
Phone (601) 969-0909

1200 N State St
Ste 420
Jackson, MS 39202
Phone (601) 355-3353

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

Interoperability endpoints

  • Direct secure messaging: ewilliams491757@direct.bmhcc.org

Organizations & group practices 9

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1205844537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST STE 420",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022027",
            "telephone_number": "601-355-3353",
            "fax_number": "601-355-3365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_2": "Department of Neurology",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-6382",
            "fax_number": "601-984-5503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MS",
            "license": "R835129",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R835129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02326761",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01653063",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.