Individual provider Active NPI

Jason L Williams, APRN

  • Family Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1558812842
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004936 Issued in AR
Practice address
1210 Wolfe St
Little Rock, AR 72202-4618
Phone
(501) 364-5150
Fax
(501) 364-3966
NPI assigned
Oct 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A004936 AR Primary

Addresses

Primary practice location

1210 Wolfe St
Little Rock, AR 72202-4618

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20170119000197 AR Practitioner - Nurse Practitioner 1850671868 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Nov 1, 2016 Accepting new patients
Arkansas Childrens Hospital CurrentSince Nov 1, 2016 Accepting new patients
Arkansas Children'S Hospital CurrentSince Nov 1, 2016 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Nov 1, 2016 Accepting new patients
University of Arkansas for Medical Sciences Past Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients

Locations

1 Childrens Way
Ste 653
Little Rock, AR 72202

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1210 Wolfe St
Little Rock, AR 72202
Phone (501) 364-3889

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

Organizations & group practices 6

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": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1558812842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 WOLFE ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722024618",
            "telephone_number": "501-364-5150",
            "fax_number": "501-364-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JASON",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-20",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.