Individual provider Active NPI

Tanya Marie Williams, APRN

  • Family Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1306469192
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3014396 Issued in KY
Practice address
200 University Drive
Elizabethtown, KY 42701-3117
Phone
(844) 435-0900
Fax
(270) 858-4029
NPI assigned
May 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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 3014396 KY Primary

Addresses

Primary practice location

200 University Drive
Elizabethtown, KY 42701-3117

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other identifiers 2

IdentifierTypeStateIssuer
14630308OtherCAQH
7100675730MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20200825001540 KY Practitioner - Nurse Practitioner 8820415623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

197 Will Walker Rd
Columbia, KY 42728-7436
Phone (270) 384-9981

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medical Center Inc Family CurrentSince Jul 13, 2020 Accepting new patients
Cumberland Family Medical Center Inc Current Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jul 13, 2020 Accepting new patients
Cumberland Family Medical Center Inc Past Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

197 Will Walker Rd
Columbia, KY 42728
Phone (270) 384-9981

1030 Commerce Dr
Elizabethtown, KY 42701
Phone (270) 506-1064

620 N Mulberry St
Elizabethtown, KY 42701
Phone (270) 769-3381

313 Morningside Dr
Elizabethtown, KY 42701
Phone (270) 769-3359

701 Hawkins Dr
Elizabethtown, KY 42701
Phone (270) 765-6146

323 Morningside Dr
Elizabethtown, KY 42701
Phone (270) 769-6343

200 University Dr
Elizabethtown, KY 42701
Phone (270) 769-7930

634 N Mulberry St
Elizabethtown, KY 42701
Phone (270) 695-3007

307 Cardinal Dr
Elizabethtown, KY 42701
Phone (270) 769-1328

2300 Nelson Dr
Elizabethtown, KY 42701
Phone (270) 769-8930

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1306469192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNIVERSITY DRIVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013117",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TANYA",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14630308",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100675730",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.