Gwendolyn Williams, C.F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R745811 Issued in MS

Practice address

401 Catchings Ave
Indianola, MS 38751-2468

Phone

(662) 887-2494

Fax

(662) 887-3208

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS, NY2 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 2

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Claxton-Hepburn Medical CenterGroup PAC ID 8426966508, 78 clinicians

Carthage Area Hospital IncGroup PAC ID 9931010485, 119 clinicians

Tunica County Healthcare AuthorityGroup PAC ID 6608898499, 8 clinicians

Northwest Miss Regional Medical CenterGroup PAC ID 3173969177, 20 clinicians

Delphi Hospitalist Services LLCGroup PAC ID 5395819478, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SLHS Massena, Inc Hospital, Massena, NY, CCN 331322
• SLHS Massena, Inc Nursing home, CCN 33Z322

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nwmgwill3@yourcarecommunity.org
• Direct secure messaging: gwilliams@cahclinics.medentdirect.com
• Direct secure messaging: gwendolyn.williams.1@29904.direct.athenahealth.com
• Direct secure messaging: gwilliams39711@mvhealthsystem.direct-ci.com

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.

• Northwest Miss Regional Medical Center

  • Internal Medicine Physician
  • Clarksdale, MS
  • NPI 1598458515
  Medicare reassignment Care Compare group NPD
• Tunica County Healthcare Authority

  • Rural Health Clinic/Center
  • Tunica, MS
  • NPI 1245360148
  Medicare reassignment Care Compare group NPD
• Carthage Area Hospital Inc

  • Critical Access Hospital
  • Carthage, NY
  • NPI 1053497388
  Medicare reassignment Care Compare group NPD
• Claxton-Hepburn Medical Center

  • Psychiatric Hospital
  • Ogdensburg, NY
  • NPI 1891753034
  Medicare reassignment Care Compare group NPD
• Delphi Hospitalist Services LLC

  • Hospitalist Physician
  • Rochester, NY
  • NPI 1922270420
  Medicare reassignment Care Compare group NPD
• Apogee Medical Group, New York, PC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1841520236

  NY

  Medicare reassignment NPD
• Delphi Healthcare PLLC

  • Emergency Medicine Physician
  • Wellsville, NY
  • NPI 1003075029

  Nurse Practitioner

  Medicare reassignment NPD
• Emergency Physician Services of New York, P.C.

  • Emergency Medicine Physician
  • Poughkeepsie, NY
  • NPI 1093759847
  Medicare reassignment NPD
• Northwest Miss Regional Medical Center

  • Emergency Medicine Physician
  • Clarksdale, MS
  • NPI 1699468686
  NPD
• Tunica County Healthcare Authority

  • Clinic/Center
  • Tunica, MS
  • NPI 1811618887
  NPD
• Carthage Area Hospital Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Ogdensburg, NY
  • NPI 1013759166
  NPD
• Carthage Area Hospital Inc.

  • Urology Physician
  • Carthage, NY
  • NPI 1720269863
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Massena Hospital Inc

  • Critical Access Hospital
  • Massena, NY
  • NPI 1972604460
  Care Compare affiliation
• Massena Hospital, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Massena, NY
  • NPI 1619756640

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1447324272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CATCHINGS AVE",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512468",
            "telephone_number": "662-887-2494",
            "fax_number": "662-887-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CATCHINGS AVE",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512468",
            "telephone_number": "662-887-2494",
            "fax_number": "662-887-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "GWENDOLYN",
        "name_prefix": "Ms.",
        "credential": "C.F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "349327",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R745811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124148",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veola'S Place
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Elizabeth Whites, FNP-BC
• Crystal Hope Williams, PTA
• Raymond Woo
• Previous J Woods, L.M.T
• Taylor Ellis Wright, PTA
• Yolandas Medical Establishment
• Whitney York, BSN, RN

• Family Nurse Practitioner in Indianola, MS
• Providers in Indianola, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.