Individual provider Active NPI

Roneseya Bentley Williams, NP-C

  • Family Nurse Practitioner
  • Bonaire, GA
National Provider Identifier
1225575277
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN199202 Issued in GA
Practice address
106 Moran Dr
Bonaire, GA 31005-5106
Phone
(478) 988-1282
Fax
(478) 988-3120
NPI assigned
Jan 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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 RN199202 GA Primary

Addresses

Primary practice location

106 Moran Dr
Bonaire, GA 31005-5106

Mailing address

106 Moran Dr
Bonaire, GA 31005-5106
Phone (478) 988-1282

Other practice location 1

725 Juniper Ln
Macon, GA 31220-7650
Phone (478) 390-0172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210617000180 GA Practitioner - Nurse Practitioner 5092115758 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN199202GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel E. Palmer, MD, PC CurrentSince Mar 1, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1225575277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MORAN DR",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310055106",
            "telephone_number": "478-988-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MORAN DR",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310055106",
            "telephone_number": "478-988-1282",
            "fax_number": "478-988-3120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Juniper Ln",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312207650",
            "country_code": "US",
            "telephone_number": "478-390-0172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RONESEYA",
        "middle_name": "BENTLEY",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN199202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonaire, GA

Sources for this page

Verify at the official NPI Registry.