Jerry Lloyd Williford, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

211128 Issued in LA

Practice address

850 Olive St Ste a
Shreveport, LA 71104-2162

Phone

(318) 239-4860

Fax

(805) 295-4715

NPI assigned

Jan 1, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern Shoshone TribeGroup PAC ID 7810422193, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sagewest Health Care Hospital, Riverton, WY, CCN 530008

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Eastern Shoshone Tribe

  • Federal Public Health Clinic/Center
  • Fort Washakie, WY
  • NPI 1770328718

  TX

  Medicare reassignment Care Compare group NPD

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

• Riverton Memorial Hospital LLC

  dba SageWest Health Care

  • Rural Acute Care Hospital
  • Lander, WY
  • NPI 1245337286
  Care Compare affiliation

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

{
    "created_epoch": "1609459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609459200000",
    "number": "1669060034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4506",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711340506",
            "telephone_number": "318-239-4860",
            "fax_number": "805-295-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 OLIVE ST STE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042162",
            "telephone_number": "318-239-4860",
            "fax_number": "805-295-4715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIFORD",
        "first_name": "JERRY",
        "middle_name": "LLOYD",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-01",
        "last_updated": "2021-01-01",
        "certification_date": "2021-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "211128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Regina Williams
• Xavier Williams
• Keith Edward Williamson
• Larrie Ann Williamson, M.D.
• Paul Williamson, ATC
• Willis Knighton Health System
• Willis Knighton Health System
• Willis Knighton Medical Center Inc. (Larry Flake, MD)
• Willis Knighton Medical Center Inc. Crna Group (Willis Knighton Anesthesia Services)
• Willis Knighton Medical Center Inc. Crna Group

• Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.