Individual provider Active NPI

Lacey Rebekah Williams

  • Nurse Practitioner
  • Asheboro, NC
National Provider Identifier
1346977816
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5016655 Issued in NC
Practice address
136 S Park St
Asheboro, NC 27203-5651
Phone
(336) 626-6371
NPI assigned
Aug 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5016655 NC
Nurse Practitioner 363L00000X 5016655 NC Primary

Addresses

Primary practice location

136 S Park St
Asheboro, NC 27203-5651

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-1331

Other practice location 1

2150 Shipyard Blvd
Wilmington, NC 28403
Phone (910) 662-9480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220830001461 NC Practitioner - Nurse Practitioner 3173907870 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
Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians

Practice addresses (Care Compare)

136 S Park St
Asheboro, NC 27203-5651
Phone (336) 626-6371

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Health Network, LLC CurrentSince Aug 22, 2022 Accepting new patients
Wake Forest Health Network LLC CurrentSince Aug 22, 2022 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Wake Forest Health Network LLC Past Accepting new patients

Locations

136 S Park St
Asheboro, NC 27203
Phone (336) 626-6371

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Interoperability endpoints

  • Direct secure messaging: lwilliams1232687@direct.novanthealth.org
  • Direct secure messaging: lwilliams2753390@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1346977816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-1331",
            "fax_number": "910-332-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S PARK ST",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035651",
            "telephone_number": "336-626-6371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Shipyard Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "28403",
            "country_code": "US",
            "telephone_number": "910-662-9480",
            "fax_number": "910-332-5666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LACEY",
        "middle_name": "REBEKAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016655",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5016655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheboro, NC

Sources for this page

Verify at the official NPI Registry.