Individual provider Active NPI

Denese A Williams, APRN

  • Primary Care Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1578060042
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN11010683 Issued in FL
Practice address
6856 Axis West Cir
Apt 3302
Orlando, FL 32821-6109
Phone
(702) 630-5620
Fax
(702) 623-7635
NPI assigned
Apr 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN11010683 FL Primary
Primary Care Nurse Practitioner 363LP2300X APRN002861 NV

Addresses

Primary practice location

6856 Axis West Cir
Apt 3302
Orlando, FL 32821-6109

Mailing address

6856 Axis West Cir
Apt 3302
Orlando, FL 32821-6109
Phone (702) 630-5620

Other practice location 1

3211 W Charleston Blvd
Las Vegas, NV 89102-1953
Phone (702) 871-3730

Other practice location 2

3211 W Charleston Blvd
Las Vegas, NV 89102-1953
Phone (702) 871-3730

Other identifiers 2

IdentifierTypeStateIssuer
APRN002861OtherNVSTATE LICENSE
1578060042MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20180502002051 NV Practitioner - Nurse Practitioner 8820352628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3211 W Charleston Blvd
Las Vegas, NV 89102-1953
Phone (702) 444-7796

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11010683FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hands & Heart Complete Care LLC Primary Care CurrentSince Aug 19, 2024 Accepting new patients
Ma Bo Inc CurrentSince Oct 20, 2023 Accepting new patients
Healthcare Partners Medical Group Coats LTD Primary Care Current Accepting new patients
Intermountain Medical Holdings Nevada Inc Past Accepting new patients
Carelon Medical Partners of Kansas, PA Past Accepting new patients

Locations

3211 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 444-7796

4625 W Nevso Dr
Ste 2AND3
Las Vegas, NV 89103
Phone (801) 485-5055

Organizations & group practices 5

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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1578060042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6856 AXIS WEST CIR",
            "address_2": "APT 3302",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216109",
            "telephone_number": "702-630-5620",
            "fax_number": "702-623-7635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6856 AXIS WEST CIR",
            "address_2": "APT 3302",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216109",
            "telephone_number": "702-630-5620",
            "fax_number": "702-623-7635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3211 W Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021953",
            "country_code": "US",
            "telephone_number": "702-871-3730",
            "fax_number": "702-871-7379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3211 W Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021953",
            "country_code": "US",
            "telephone_number": "702-871-3730",
            "fax_number": "702-871-7379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DENESE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11010683",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NV",
            "license": "APRN002861",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "APRN002861",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578060042",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.