Individual provider Active NPI

Kristin Williams, ARNP

  • Nurse Practitioner
  • Puyallup, WA
National Provider Identifier
1508620824
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP61526348 Issued in WA
Practice address
611 31St Ave SW
Puyallup, WA 98373-3723
Phone
(253) 848-5951
Fax
(253) 845-7073
NPI assigned
Feb 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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 AP61526348 WA Primary

Addresses

Primary practice location

611 31St Ave SW
Puyallup, WA 98373-3723

Mailing address

3908 10TH St SE
Puyallup, WA 98374-2188
Phone (253) 848-5951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240222002409 WA Practitioner - Nurse Practitioner 8921442526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Hill Family Medicine PCGroup PAC ID 8729980396, 67 clinicians

Practice addresses (Care Compare)

611 31St Ave SW
Suite C
Puyallup, WA 98373-3723
Phone (253) 848-5951

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61526348WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Hill Family Medicine PC CurrentSince Apr 1, 2024 Accepting new patients

Locations

611 31st Ave SW
Ste C
Puyallup, WA 98373
Phone (253) 848-5951

3908 10th St SE
Puyallup, WA 98374
Phone (253) 848-5951

611 31st Ave SW
Puyallup, WA 98373
Phone (253) 445-7100

Interoperability endpoints

  • Direct secure messaging: kwilliams76245@direct.tecmc.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1508620824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 10TH ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742188",
            "telephone_number": "253-848-5951",
            "fax_number": "253-845-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 31ST AVE SW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733723",
            "telephone_number": "253-848-5951",
            "fax_number": "253-845-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KRISTIN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61526348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.