Caitlin Maree Defazio Williams, NP-C
Individual provider Active NPI Family Nurse Practitioner · Thaxton, MS
NPI 1437622909 · NPPES record last updated Apr 15, 2020
Key facts
- NPI
- 1437622909
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 903099 (MS)
- Practice address
- 11145 Highway 6 W
Thaxton, MS 38871-9024 - Phone
- (662) 489-8500
- NPI assigned
- Jan 8, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- North Mississippi Medical Center, Inc.
Practice addresses (Care Compare)
4579 S Eason Blvd
Tupelo, MS 38801-6539
806 Garfield St
Tupelo, MS 38801-5749
Phone (662) 377-5395
Hospital & facility affiliations
- North Mississippi Medical Ctr HHA
- North Mississippi Medical Center
- Tishomingo Health Services Inc
- North Mississippi Medical Center-Gilmore Amory
- Clay County Medical Corporation
- Baptist Memorial Hospital Booneville
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200420001847 | MS | Practitioner - Nurse Practitioner | 5395175145 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Mississippi Medical Center | Current |
Accepting new patients | |
| North Mississippi Medcial Center, Inc. | Current |
Accepting new patients | |
| North Mississippi Medical Center Inc | Current | Accepting new patients | |
| North Mississippi Medical Center | Current | Accepting new patients | |
| Thaxton Family Medical Clinic LLC | Past | Accepting new patients | |
| Amory Surgery Clinic, PLLC | Past | Accepting new patients | |
| Thaxton Medical Clinic, LLC | Past |
Accepting new patients |
Locations
4579 S Eason Blvd
Ste A
Tupelo, MS 38801
Phone (662) 377-6161
806 Garfield St
Tupelo, MS 38801
Phone (662) 377-5395
4579 S Eason Blvd
Ste Ef
Tupelo, MS 38801
Phone (662) 377-7590
Interoperability endpoints
- https://api.platform.athenahealth.com/13556/brand/1/csg/1/fhir/r4
- caitlinwilliams@nmhs.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 903099 | MS | Yes |
Addresses
Primary practice location
11145 Highway 6 W
Thaxton, MS 38871-9024
Mailing address
128 Calloway Loop
Pontotoc, MS 38863-6102
Phone (662) 317-9783
Other providers in Thaxton, MS
- Carley Walker Herndon
- Kacie Cameron Hollimon
- Cassie Bradley Taylor
- Thaxton Family Medical Clinic LLC
- Thaxton Medical Clinic, LLC
- Okwuchi Lilian Worthem
All providers in Thaxton, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.