Tasha H Williams, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042081A Issued in IN

Practice address

11104 Parkview Circle Dr
Ste 110
Fort Wayne, IN 46845-1730

Phone

(260) 460-3100

Fax

(260) 460-3130

NPI assigned

Jun 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fort Wayne Neuropsychology LLCGroup PAC ID 0345526893, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Fort Wayne Neuropsychology LLC

  • Clinical Neuropsychologist
  • Fort Wayne, IN
  • NPI 1871032862
  Medicare reassignment Care Compare group NPD Authorized official
• Parkview Health System Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1932130952
  Medicare reassignment NPD

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1467499780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11104 PARKVIEW CIRCLE DR",
            "address_2": "STE 110",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451730",
            "telephone_number": "260-460-3100",
            "fax_number": "260-460-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 PARKVIEW CIRCLE DR",
            "address_2": "STE 110",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451730",
            "telephone_number": "260-460-3100",
            "fax_number": "260-460-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TASHA",
        "middle_name": "H",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042081A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200816640",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00399217",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2705719",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Williams
• Rochelle Williams
• Shavonte Williams
• Sierra Williams
• Staci Williams
• Terra Marie Williams, MPT
• Bridgette E. Williamson, MS
• Ebony Williamson, RBT, BS
• Meredith Williamson
• Sheri Nadine Willians

• Clinical Psychologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.