NPIMap

Individual provider Active NPI

Patricia Mason Williamson, NP

  • Primary Care Nurse Practitioner
  • Bowling Green, VA
National Provider Identifier
1285334078
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
0024186324 Issued in VA
Practice address
102 W Broaddus Ave
Suite 200
Bowling Green, VA 22427-1596
Phone
(804) 632-1030
Fax
(804) 632-1033
NPI assigned
Mar 9, 2023
Last updated
Mar 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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 0024186324 VA Primary

Addresses

Primary practice location

102 W Broaddus Ave
Suite 200
Bowling Green, VA 22427-1596

Mailing address

PO Box 1596
Bowling Green, VA 22427-1596
Phone (804) 632-1030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230522002547 VA Practitioner - Nurse Practitioner 4183080815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

102 W Broaddus Ave
Suite 200
Bowling Green, VA 22427-9404
Phone (804) 632-1030

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024186324VAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Virginia Health Services Inc Current Accepting new patients
Central Virginia Health Services Inc CurrentSince Mar 20, 2023 Accepting new patients
Central Virginia Health Services Inc CurrentSince Mar 20, 2023 Accepting new patients
Central Virginia Health Services Inc Past Accepting new patients

Locations

25892 N James Madison Hwy
New Canton, VA 23123
Phone (434) 581-3271

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1285334078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1596",
            "city": "BOWLING GREEN",
            "state": "VA",
            "postal_code": "224271596",
            "telephone_number": "804-632-1030",
            "fax_number": "804-632-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W BROADDUS AVE",
            "address_2": "SUITE 200",
            "city": "BOWLING GREEN",
            "state": "VA",
            "postal_code": "224271596",
            "telephone_number": "804-632-1030",
            "fax_number": "804-632-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "PATRICIA",
        "middle_name": "MASON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024186324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, VA

Sources for this page

Verify at the official NPI Registry.