Individual provider Active NPI

Madison Williams, APRN, FNP-C

  • Family Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1639827124
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202200212 Issued in MO
Practice address
1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone
(573) 331-4822
NPI assigned
Mar 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 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 202200212 MO Primary

Addresses

Primary practice location

1701 Lacey St
Cape Girardeau, MO 63701-5230

Mailing address

2126 Independence St
Cape Girardeau, MO 63703-5826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20220421002056 MO Practitioner - Nurse Practitioner 8921495953 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202200212MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Missouri Hospital Physicians, LLC CurrentSince Apr 11, 2022 Accepting new patients

Locations

2126 Independence St
Cape Girardeau, MO 63703
Phone (573) 986-4411

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

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.

NPI Registry JSON

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1639827124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2126 INDEPENDENCE ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 LACEY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637015230",
            "telephone_number": "573-331-4822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MADISON",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-05-04",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "202200212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.