Roderickus Williams, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

221798 Issued in LA

Practice address

8930 Bayonne Dr
Shreveport, LA 71118-2033

Phone

(318) 455-2898

NPI assigned

Feb 27, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brentwood Acquisition-Shreveport IncGroup PAC ID 1951379312, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rwilliams608735@christushealth.direct-ci.net

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.

• Brentwood Acquisition-Shreveport Inc.

  • Psychiatry Physician
  • Shreveport, LA
  • NPI 1164725701
  Medicare reassignment Care Compare group NPD
• Elite Health

  • Psychiatry Physician
  • Shreveport, LA
  • NPI 1710755798
  Medicare reassignment NPD
• Brentwood Acquisition-Shreveport Inc.

  • Psychiatric Hospital
  • Shreveport, LA
  • NPI 1417979204
  NPD

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628899200000",
    "number": "1679965610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9542 LUCIEN WAY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711063432",
            "telephone_number": "318-455-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 BAYONNE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182033",
            "telephone_number": "318-455-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RODERICKUS",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-27",
        "last_updated": "2021-08-14",
        "certification_date": "2021-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "146918",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "221798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Lynette Williams, RSW/CAC
• Patrice Williams
• Patti McBride Williams, LPC, LMFT
• Queyarner Williams
• Robert Bruce Williams, MD
• Roquel A Williams, PHD, MD
• Rosalind Lea Williams
• Rush Williams
• Ryan Williams
• Samerrial Williams, FNP

• Psychiatric/Mental Health Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.