Individual provider Active NPI

Tumesha Lashay Williams, NP

  • Obstetrics & Gynecology Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1497120414
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
RN205755 Issued in GA
Practice address
1279 Highway 54 W Ste 100
Fayetteville, GA 30214-4551
Phone
(770) 719-5710
NPI assigned
Dec 2, 2015
Last updated
Oct 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN205755 GA
Obstetrics & Gynecology Nurse Practitioner 363LX0001X RN205755 GA Primary

Addresses

Primary practice location

1279 Highway 54 W Ste 100
Fayetteville, GA 30214-4551

Mailing address

1046 Ridge Ave SW
Atlanta, GA 30315-1640
Phone (404) 688-1350

Other practice location 1

1046 Ridge Ave SW
Atlanta, GA 30315-1640
Phone (404) 688-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 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

Enrollment IDStateProvider typePAC IDDetails
I20160302002508 NC Practitioner - Nurse Practitioner 7810290517
I20170523000471 GA Practitioner - Nurse Practitioner 7810290517 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5008305NCMDFamily Nurse Practitioner
RN205755GAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Medical Center, Inc. CurrentSince Feb 21, 2017 Accepting new patients
Southside Medical Center, Inc CurrentSince Feb 21, 2017 Accepting new patients
Allara Medical Group PA Past Accepting new patients

Locations

1046 Ridge Ave SW
Atlanta, GA 30315
Phone (404) 564-6942

1039 Ridge Ave SW
Atlanta, GA 30315
Phone (407) 761-8640

Interoperability endpoints

  • Direct secure messaging: tumesha.williams@335000925634564.direct.elationemr.com
  • Direct secure messaging: tumesha.williams.1@29536.direct.athenahealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1497120414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 RIDGE AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303151640",
            "telephone_number": "404-688-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 HIGHWAY 54 W STE 100",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144551",
            "telephone_number": "770-719-5710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1046 Ridge Ave SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303151640",
            "country_code": "US",
            "telephone_number": "404-688-1350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TUMESHA",
        "middle_name": "LASHAY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-02",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN205755",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "GA",
            "license": "RN205755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.