Individual provider Active NPI

Debra Ann Williston, CRNP

  • Adult Health Nurse Practitioner
  • Allentown, PA
National Provider Identifier
1669477543
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP007862 Issued in PA
Practice address
1230 S Cedar Crest Blvd Stes 301, 302, 304
Allentown, PA 18103-6212
Phone
(610) 432-4529
Fax
(610) 432-2206
NPI assigned
Jun 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP007862 PA
Critical Care Medicine Nurse Practitioner 363LC0200X SP007862 PA
Adult Health Nurse Practitioner 363LA2200X SP007862 PA Primary

Addresses

Primary practice location

1230 S Cedar Crest Blvd Stes 301, 302, 304
Allentown, PA 18103-6212

Mailing address

1230 S Cedar Crest Blvd Ste 301
Allentown, PA 18103-6212
Phone (610) 432-4529

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwilliston12207@direct.acumenmd.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040622001312 PA Practitioner - Nurse Practitioner 7618952847 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Kidney Specialists, P.C.Group PAC ID 2860670734, 31 clinicians

Practice addresses (Care Compare)

1230 S Cedar Crest Blvd
Allentown, PA 18103-6212
Phone (610) 432-4529

45 Constitution Blvd
Kutztown, PA 19530-1737
Phone (610) 432-4529

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP007862PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Kidney Specialists, PC CurrentSince May 15, 2011 Accepting new patients
Valley Kidney Specialists, P.C. CurrentSince May 15, 2011 Accepting new patients
Kidney Care Specialists LLC CurrentSince Nov 1, 2018 Accepting new patients

Locations

1230 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 432-4873

1230 S Cedar Crest Blvd
Ste 30130
Allentown, PA 18103

2014 City Line Rd
Ste 103
Bethlehem, PA 18017
Phone (610) 433-4100

2014 City Line Rd
Ste 300
Bethlehem, PA 18017

2000 Sproul Rd
Ste 300
Broomall, PA 19008
Phone (610) 356-3700

45 Constitution Blvd
Kutztown, PA 19530
Phone (610) 683-7349

168 S Sgt Stanley Hoffman Blvd
#209
Lehighton, PA 18235
Phone (610) 379-0330

1105 Bethlehem Pike
#B5
Sellersville, PA 18960
Phone (215) 257-4533

920 Lawn Ave
Ste 12
Sellersville, PA 18960
Phone (215) 257-4533

Interoperability endpoints

  • Direct secure messaging: dwilliston12207@direct.acumenmd.com

Organizations & group practices 4

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1669477543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD STE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036212",
            "telephone_number": "610-432-4529",
            "fax_number": "610-432-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD STES 301, 302, 304",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036212",
            "telephone_number": "610-432-4529",
            "fax_number": "610-432-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLISTON",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP007862",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "PA",
            "license": "SP007862",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP007862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwilliston12207@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "1230 S Cedar Crest Blvd Stes 301, 302, 304",
            "city": "Allentown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "181036212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.