Individual provider Active NPI

Cynthia Williams, APRN-BC

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1689740185
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
142016 Issued in MO
Practice address
11133 Dunn Rd
Saint Louis, MO 63136-6119
Phone
(314) 317-0600
Fax
(314) 317-0606
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 142016 MO Primary

Addresses

Primary practice location

11133 Dunn Rd
Saint Louis, MO 63136-6119

Mailing address

12101 Woodcrest Executive Dr
Suite 210
Saint Louis, MO 63141-5047
Phone (314) 317-0600

Other identifiers 2

IdentifierTypeStateIssuer
1689740185MedicaidMO
1689740185MedicaidIL

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
I20070302000008 MO Practitioner - Nurse Practitioner 8224130729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 653-4450

Hospital & facility affiliations

  • Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC CurrentSince Jul 1, 2016 Accepting new patients
Hospital Medicine Services of Tennessee PC Adult Health CurrentSince Jul 8, 2021 Accepting new patients
Simran Behavioral Health Past Accepting new patients
Inpatient Consultants of Missouri Inc Past Accepting new patients
Kirpa LLC Past Accepting new patients
GBNP, LLC Adult Health Past Accepting new patients

Locations

936 Charbonier Rd
Florissant, MO 63031
Phone (314) 831-4800

1432 Southwest Blvd
Jefferson Cty, MO 65109
Phone (573) 632-5560

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1689740185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 WOODCREST EXECUTIVE DR",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415047",
            "telephone_number": "314-317-0600",
            "fax_number": "314-317-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366119",
            "telephone_number": "314-317-0600",
            "fax_number": "314-317-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CYNTHIA",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "142016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689740185",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689740185",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.