Individual provider Active NPI

Tricia Anne Williams, NP -C

  • Adult Health Nurse Practitioner
  • Ashtabula, OH
National Provider Identifier
1528341187
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
COA.12640 - NP Issued in OH
Practice address
1111 Lake Ave
Ashtabula, OH 44004-2929
Phone
(440) 964-7121
Fax
(440) 964-2251
NPI assigned
Sep 21, 2011
Last updated
Sep 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X COA.12640 - NP OH Primary

Addresses

Primary practice location

1111 Lake Ave
Ashtabula, OH 44004-2929

Mailing address

1111 Lake Ave
Ashtabula, OH 44004-2929
Phone (440) 964-7121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120302000280 OH Practitioner - Nurse Practitioner 1355515040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sam Mhanna MD LLCGroup PAC ID 1153748439, 2 clinicians

Practice addresses (Care Compare)

1111 Lake Ave
Ashtabula, OH 44004-2929
Phone (440) 964-7121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.12640 - NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sam Mhanna MD LLC CurrentSince Sep 15, 2020 Accepting new patients

Locations

1111 Lake Ave
Ashtabula, OH 44004
Phone (440) 964-7121

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1528341187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440042929",
            "telephone_number": "440-964-7121",
            "fax_number": "440-964-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440042929",
            "telephone_number": "440-964-7121",
            "fax_number": "440-964-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TRICIA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "NP -C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.12640 - NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

Verify at the official NPI Registry.