Individual provider Active NPI

Tarneisha Williams, NP

  • Primary Care Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1730757808
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN235977 Issued in GA
Practice address
1862 Candler Rd
Decatur, GA 30032-4163
Phone
(404) 289-4556
Fax
(404) 478-2779
NPI assigned
Jun 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN235977 GA
Adult Health Nurse Practitioner 363LA2200X RN235977 GA
Gerontology Nurse Practitioner 363LG0600X RN239577 GA
Primary Care Nurse Practitioner 363LP2300X RN235977 GA Primary

Addresses

Primary practice location

1862 Candler Rd
Decatur, GA 30032-4163

Mailing address

130 Shaker Hollow Dr
McDonough, GA 30253-7590
Phone (478) 320-3157

Other practice location 1

130 Shaker Hollow Dr
McDonough, GA 30253-7590
Phone (478) 320-3157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20251013000141 GA Practitioner - Nurse Practitioner 1951898261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5410 Maryland Way
Suite 400
Brentwood, TN 37027-8087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN235977GAMDAdult Health Nurse Practitioner
RN239577GAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monogram Health Professional Services PC CurrentSince Sep 29, 2025 Accepting new patients
Monogram Health Professional Services PC CurrentSince Sep 29, 2025 Accepting new patients

Locations

3350 Riverwood Pkwy SE
Ste 1900
Atlanta, GA 30339
Phone (404) 277-2167

Interoperability endpoints

  • Direct secure messaging: tarneisha.williams.1@22854.direct.athenahealth.com

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": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1730757808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SHAKER HOLLOW DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537590",
            "telephone_number": "478-320-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1862 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300324163",
            "telephone_number": "404-289-4556",
            "fax_number": "404-478-2779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Shaker Hollow Dr",
            "address_purpose": "LOCATION",
            "city": "McDonough",
            "state": "GA",
            "postal_code": "302537590",
            "country_code": "US",
            "telephone_number": "478-320-3157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TARNEISHA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN235977",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN235977",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN239577",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN235977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.