Individual provider Active NPI

Lacey Williams, FNP-BC

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1700501004
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN1096006 Issued in TX
Practice address
22015 W Interstate 10 Ste 204
San Antonio, TX 78257-2104
Phone
(210) 446-6263
NPI assigned
Oct 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN1096006 TX Primary

Addresses

Primary practice location

22015 W Interstate 10 Ste 204
San Antonio, TX 78257-2104

Mailing address

22015 W Interstate 10 Ste 204
San Antonio, TX 78257-2104
Phone (210) 446-6263

Other identifiers 1

IdentifierTypeStateIssuer
APRN1096006OtherTXAPRN LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221119000033 TX Practitioner - Nurse Practitioner 9133597347

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN1096006TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yolanda Marcos MD PA CurrentSince Nov 1, 2022 Accepting new patients
Hillside Primary Care PLLC PastSince Nov 1, 2022 Accepting new patients

Locations

510 Med Ct
Ste 210
San Antonio, TX 78258
Phone (210) 494-4290

Organizations & group practices 2

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1700501004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22015 W INTERSTATE 10 STE 204",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782572104",
            "telephone_number": "210-446-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22015 W INTERSTATE 10 STE 204",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782572104",
            "telephone_number": "210-446-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LACEY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "APRN1096006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "APRN1096006",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.