Individual provider Active NPI

Elicia Williams, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Wentzville, MO
National Provider Identifier
1316718505
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023045469 Issued in MO
Practice address
1032 Crosswinds CT
Wentzville, MO 63385-4836
Phone
(844) 853-8937
NPI assigned
Jan 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2016030199 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023045469 MO Primary

Addresses

Primary practice location

1032 Crosswinds CT
Wentzville, MO 63385-4836

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (844) 853-8937

Other practice location 1

860 Lynn St
Lebanon, MO 65536-3810
Phone (844) 853-8937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240212003637 MO Practitioner - Nurse Practitioner 4284077769 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016030199MOMDRegistered Nurse
2023045469MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Feb 12, 2024 Accepting new patients
Compass Health, Inc CurrentSince Feb 12, 2024 Accepting new patients

Locations

1800 Community
#B
Clinton, MO 64735

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

860 Lynn St
Lebanon, MO 65536
Phone (417) 334-8337

19515 Brune Pkwy
Warrenton, MO 63383
Phone (636) 235-4049

1032 Crosswinds Ct
Wentzville, MO 63385
Phone (636) 332-6000

Organizations & group practices 2

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": "1705363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1316718505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "844-853-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 CROSSWINDS CT",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633854836",
            "telephone_number": "844-853-8937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "860 Lynn St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "MO",
            "postal_code": "655363810",
            "country_code": "US",
            "telephone_number": "844-853-8937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ELICIA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2016030199",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2023045469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

Verify at the official NPI Registry.