NPIMap

Individual provider Active NPI

Nicole Williamson, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1326826959
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118046 Issued in FL
Practice address
12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone
(813) 745-7365
Fax
(813) 449-8618
NPI assigned
Sep 15, 2023
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9118046 FL Primary

Addresses

Primary practice location

12902 Usf Magnolia Dr
Tampa, FL 33612-9416

Mailing address

8293 Birch Haven LN
New Port Richey, FL 34655-5520
Phone (843) 333-6995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231109002424 FL Practitioner - Physician Assistant 2769839984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

5347 Main St
Suite 202
New Port Richey, FL 34652-2520
Phone (727) 841-0515

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Synergic Healthcare Solutions LLC CurrentSince Oct 30, 2023 Accepting new patients
Synergic Healthcare Solutions LLC CurrentSince Sep 17, 2023 Accepting new patients
Tampa General Hospital Current Accepting new patients
Synergic Healthcare Solutions LLC CurrentSince Oct 30, 2023 Accepting new patients
Synergic Healthcare Solutions LLC Current Accepting new patients

Locations

13531 State Road 54
Odessa, FL 33556

5504 Gateway Blvd
Wesley Chapel, FL 33544
Phone (813) 948-5400

16521 US 301 S
Wimauma, FL 33598
Phone (813) 844-4700

200 N Bryant Ave
Ste 10
Edmond, OK 73034

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/DEDJAA/Endpoint/DEDJAA
  • Direct secure messaging: nfreede278897@direct.tgh.org

Organizations & group practices 7

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 5

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": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "number": "1326826959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8293 BIRCH HAVEN LN",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346555520",
            "telephone_number": "843-333-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12902 USF MAGNOLIA DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129416",
            "telephone_number": "813-745-7365",
            "fax_number": "813-449-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.