Individual provider Active NPI

Crystal Christine Williams, APN

  • Family Nurse Practitioner
  • Maryville, TN
National Provider Identifier
1326365925
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14919 Issued in TN
Practice address
1103 E. Lamar Alexander Pkwy
Maryville, TN 37804
Phone
(865) 977-1818
Fax
(865) 977-1801
NPI assigned
Apr 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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 14919 TN Primary

Addresses

Primary practice location

1103 E. Lamar Alexander Pkwy
Maryville, TN 37804

Mailing address

1601 Wilkinson Pike
Maryville, TN 37803-6205
Phone (865) 806-6077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20161026001513 TN Order and Referring Only - Nurse Practitioner 7012031891

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blount Memorial Physician Group, Inc CurrentSince Jan 1, 2011 Accepting new patients
Avatar Medical Inc. PastSince Mar 29, 2004 Accepting new patients
East Tennessee Medical Group, PC Past Accepting new patients

Locations

463 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5100

710 Morganton Square Dr
Maryville, TN 37801
Phone (865) 380-4021

458 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5355

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1326365925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WILKINSON PIKE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378036205",
            "telephone_number": "865-806-6077",
            "fax_number": "865-977-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 E. LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37804",
            "telephone_number": "865-977-1818",
            "fax_number": "865-977-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CRYSTAL",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "14919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.