Individual provider Active NPI

Kristy Leanne Williams, CRNP

  • Nurse Practitioner
  • Madison, AL
National Provider Identifier
1447798616
Registry record updated Dec 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1143411 Issued in AL
Practice address
400 Sun Temple Dr
Madison, AL 35758-5924
Phone
(256) 774-5524
NPI assigned
Feb 7, 2017
Last updated
Dec 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1143411 AL Primary

Addresses

Primary practice location

400 Sun Temple Dr
Madison, AL 35758-5924

Mailing address

400 Sun Temple Dr
Madison, AL 35758-5924
Phone (256) 774-5524

Other identifiers 2

IdentifierTypeStateIssuer
51189973OtherALBCBC
196237MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20170525000690 AL Practitioner - Nurse Practitioner 9739456658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Madison Primary Care LLCGroup PAC ID 0042494346, 6 clinicians

Practice addresses (Care Compare)

3776 Sullivan St
Suite D
Madison, AL 35758-2344

3776 Sullivan St D
Madison, AL 35758-2344

400 Sun Temple Dr
Madison, AL 35758-5924
Phone (256) 774-5524

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1143411ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Primary Care LLC CurrentSince Jan 6, 2023 Accepting new patients
Premier Family Care, LLC CurrentSince Apr 2, 2017 Accepting new patients
Premier Family Care, LLC PastSince Apr 2, 2017 Accepting new patients

Locations

2017 Obrig Ave
Guntersville, AL 35976
Phone (256) 582-2324

1407 Blount Ave
Guntersville, AL 35976
Phone (256) 582-2324

400 Sun Temple Dr
Madison, AL 35758
Phone (256) 774-5524

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12216/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kristy.williams.1@12216.direct.athenahealth.com
  • Direct secure messaging: kristy.williams.premierfamilycarearab@pfca.direct.systemedx.com

Organizations & group practices 3

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 3

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": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672444800000",
    "number": "1447798616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585924",
            "telephone_number": "256-774-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585924",
            "telephone_number": "256-774-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KRISTY",
        "middle_name": "LEANNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-07",
        "last_updated": "2022-12-31",
        "certification_date": "2022-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1143411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBC",
            "identifier": "51189973",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196237",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.