Kathleen Joy Williams, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

0024184325 Issued in VA

Practice address

321 Poplar Dr Ste C
Petersburg, VA 23805-9391

Phone

(804) 733-5591

NPI assigned

May 26, 2022

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 VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleen.williams.1@14940.direct.athenahealth.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.

• Central Virginia Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Petersburg, VA
  • NPI 1134258601
  Medicare reassignment NPD
• Central Virginia Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Petersburg, VA
  • NPI 1588878474
  NPD
• Central Virginia Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Hopewell, VA
  • NPI 1972264869
  NPD

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1508504705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 POPLAR DR STE C",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 POPLAR DR STE C",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059391",
            "telephone_number": "804-733-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KATHLEEN",
        "middle_name": "JOY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024184325",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024184325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "0024184325",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Wilkins
• William M Ballance DDS
• Annetta Williams, LCSW
• Ashley Nicole Williams, PHARM D.
• Frankie P Williams, RPH
• Matthew S Williams, ATC
• Michelle Denise Williams, RN
• Sandra G Williams
• Simmone J Williams
• Lori Wilson

• Primary Care Nurse Practitioner in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Primary Care Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.