Individual provider Active NPI

Valina Williams

  • Psychiatric/Mental Health Nurse Practitioner
  • Leland, MS
National Provider Identifier
1447928148
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
904779 Issued in MS
Practice address
513 NE Deer Creek Dr
Leland, MS 38756-2811
Phone
(662) 390-6052
NPI assigned
Aug 30, 2021
Last updated
Aug 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 904779 MS Primary

Addresses

Primary practice location

513 NE Deer Creek Dr
Leland, MS 38756-2811

Mailing address

PO Box 495
Leland, MS 38756-0495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20221130002561 MS Practitioner - Nurse Practitioner 6608244371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Serenity of Mississippi LLCGroup PAC ID 2860780111, 4 clinicians

Practice addresses (Care Compare)

300 S Washington Ave
Greenville, MS 38701-4719
Phone (337) 802-1336

365 W Reed Rd
Suite B
Greenville, MS 38701-6967
Phone (662) 390-6052

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Oasis Inc CurrentSince Sep 10, 2023 Accepting new patients
Access Serenity of Mississippi LLC CurrentSince Jun 10, 2024 Accepting new patients
Healing Hearts Center LLC Psychiatric/Mental Health CurrentSince May 12, 2023 Accepting new patients
Ely Psychiatric Services LLC Psychiatric/Mental Health PastSince Jun 10, 2024 Accepting new patients

Locations

2837 Ernest St
Ste C
Lake Charles, LA 70601
Phone (337) 274-2689

810 E Sunflower Rd
Ste 140
Cleveland, MS 38732
Phone (662) 588-3911

1700 S Colorado St
Greenville, MS 38703
Phone (662) 207-4610

300 S Washington Ave
Greenville, MS 38701
Phone (662) 378-2020

365 W Reed Rd
#B
Greenville, MS 38701
Phone (662) 390-6052

205 N Cherry St
Magnolia, MS 39652
Phone (225) 929-7380

Interoperability endpoints

  • Direct secure messaging: valina.williams.p1@direct.gacfhc.nextgenshare.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": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1447928148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 495",
            "city": "LELAND",
            "state": "MS",
            "postal_code": "387560495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 NE DEER CREEK DR",
            "city": "LELAND",
            "state": "MS",
            "postal_code": "387562811",
            "telephone_number": "662-390-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "VALINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "904779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, MS

Sources for this page

Verify at the official NPI Registry.