Individual provider Active NPI

Nicole Williams, CRNA

  • Certified Registered Nurse Anesthetist
  • Lumberton, NC
National Provider Identifier
1699537969
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
153000 Issued in NC
Practice address
300 W 27TH St
Lumberton, NC 28358-3075
Phone
(910) 671-5000
NPI assigned
Jan 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 153000 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X
Registered Nurse 163W00000X 741019 TX

Addresses

Primary practice location

300 W 27TH St
Lumberton, NC 28358-3075

Mailing address

1405 Vergeland Dr
Hope Mills, NC 28348-7549
Phone (715) 965-6009

Other practice location 1

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-6949

Other practice location 2

5220 Essen Ln
Baton Rouge, LA 70809-3542
Phone (225) 526-2972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250129001434 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860921376 Reassigns benefits to 2 organizations
I20260511001972 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860921376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reston Anesthesia Associates PCGroup PAC ID 2567361124, 52 clinicians
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

1850 Town Ctr Pkwy
Reston, VA 20190-3204
Phone (703) 689-9000

300 W 27TH St
Lumberton, NC 28358-3075
Phone (910) 671-5000

Hospital & facility affiliations

  • Southeastern Regional Medical Center Hospital, Lumberton, NC, CCN 340050
  • Reston Hospital Center Hospital, Reston, VA, CCN 490107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7653NCMDGeneral Practice Dentistry
741019TXMDRegistered Nurse
153000NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 20, 2025 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Cumberland County Hospital System Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 31, 2025 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Mar 31, 2025 Accepting new patients

Locations

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

Organizations & group practices 5

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": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1699537969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 VERGELAND DR",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283487549",
            "telephone_number": "715-965-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583075",
            "telephone_number": "910-671-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-6949",
            "fax_number": "910-321-6253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5220 Essen Ln",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708093542",
            "country_code": "US",
            "telephone_number": "225-526-2972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "NICOLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "153000",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "741019",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.