Individual provider Active NPI

Augusta Williams

  • Psychiatric/Mental Health Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1407402910
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN198395 Issued in GA
Practice address
Attn: Augusta Williams
2131 Kingston Court Suite 108
Marietta, GA 30067-8929
Phone
(678) 772-7415
NPI assigned
Aug 12, 2019
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AC002939 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN198395 GA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5012108 NC

Addresses

Primary practice location

Attn: Augusta Williams
2131 Kingston Court Suite 108
Marietta, GA 30067-8929

Mailing address

174 Thorncliff Way Ste 108
Acworth, GA 30101-2644
Phone (678) 887-5083

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chps@corehealthprovider.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, DC, GA, IA, MD5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20200318000767 NC Practitioner - Nurse Practitioner 6901234384 Reassigns benefits to 1 organization
I20210107002391 DC Practitioner - Nurse Practitioner 6901234384
I20210113003060 GA Practitioner - Nurse Practitioner 6901234384 Reassigns benefits to 2 organizations
I20221012002876 IA Practitioner - Nurse Practitioner 6901234384 Reassigns benefits to 1 organization
I20240301000252 MD Practitioner - Nurse Practitioner 6901234384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Drexel University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

205 Sherwood Rd
Jacksonville, NC 28540-5534
Phone (866) 932-7654

2131 Kingston CT SE
Suite 112
Marietta, GA 30067-8929
Phone (866) 932-7654

4811 Bayonne Ave
Apt a
Baltimore, MD 21206-7624
Phone (866) 932-7654

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN198395GAMDPsychiatric/Mental Health Nurse Practitioner
AC002939MDMDPsychiatric/Mental Health Nurse Practitioner
5012108NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Corehealthpsych Psychiatric/Mental Health CurrentSince Mar 1, 2023 Accepting new patients
Core Health Provider Services, Inc CurrentSince Dec 15, 2020 Accepting new patients
Psychiatric Healing for All LLC Psychiatric/Mental Health PastSince Aug 16, 2022 Accepting new patients

Locations

2131 Kingston Ct SE
Ste 108
Marietta, GA 30067
Phone (678) 695-7137

2131 Kingston Ct SE
Ste 11
Marietta, GA 30067
Phone (866) 932-7654

2131 Kingston Ct SE
Ste 112
Marietta, GA 30067
Phone (866) 932-7654

Interoperability endpoints

  • Direct secure messaging: chps@corehealthprovider.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1407402910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 THORNCLIFF WAY STE 108",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301012644",
            "telephone_number": "678-887-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ATTN: AUGUSTA WILLIAMS",
            "address_2": "2131 KINGSTON COURT SUITE 108",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678929",
            "telephone_number": "678-772-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "AUGUSTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "AC002939",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN198395",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5012108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chps@corehealthprovider.com",
            "affiliation": "N",
            "address_1": "ATTN: AUGUSTA WILLIAMS",
            "address_2": "2131 Kingston Court Suite 108",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300678929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.