Jennifer Renae Williams, MD

Key facts

NPI

1265637870

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

MD203638 (LA)

Practice address

901 Gause Blvd
First Floor
Slidell, LA 70458-2937

Phone

(985) 280-8971

Fax

(985) 280-2618

NPI assigned

Jun 15, 2007

Sex

Female

Sole proprietor

No

Organizations & group practices 8

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.

• Beauregard Family Medical Center, LLC Multi-Specialty Clinic/Center · Deridder, LA · NPI 1326387705
  Medicare reassignment NPD LA
• Convenient Care LLC Urgent Care Clinic/Center · Baton Rouge, LA · NPI 1164422630
  Medicare reassignment NPD LA
• Lake Urgent Care Ascension LLC Urgent Care Clinic/Center · Prairieville, LA · NPI 1912243122
  Medicare reassignment NPD LA
• Convenient Care LLC Urgent Care Clinic/Center · Hammond, LA · NPI 1225119225
  NPD
• Convenient Care LLC Urgent Care Clinic/Center · Baton Rouge, LA · NPI 1497848477
  NPD
• Lake Urgent Care Ascension LLC Urgent Care Clinic/Center · Saint Amant, LA · NPI 1487024618
  NPD
• Slidell Memorial Hospital Specialist · Slidell, LA · NPI 1558301093
  NPD (past)
• Highline Medical Group Inc Family Medicine Physician · Burien, WA · NPI 1982652400
  NPD (past) FAMILY MEDICINE

Medicare participation

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 27, 2023.

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1265637870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 FULTON ST # 11C",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 GAUSE BLVD",
            "address_2": "FIRST FLOOR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582937",
            "telephone_number": "985-280-8971",
            "fax_number": "985-280-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "middle_name": "RENAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60079331",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116019549",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD203638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

• Demetra Williams
• Ebony Williams
• Gerald Alan Williams, DDS
• Jade Williams
• Janetta Williams
• Kartrina Lyn Williams
• Leticia Lynette Williams
• Marilyn Suzette Williams, LCSW
• Meesha Williams
• Raven Williams

All providers in Slidell, LA · Family Medicine Physician in Louisiana