Jenna Holland Williams, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN195918 Issued in GA

Practice address

2015 Alice St
Waycross, GA 31501-6209

Phone

(912) 490-3633

NPI assigned

Feb 15, 2020

Last updated

Jun 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18622/brand/1/csg/1/fhir/r4
• Direct secure messaging: jenna.williams@bacon.gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Trimed Advance Health, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Waycross, GA
  • NPI 1689140600
  Medicare reassignment NPD
• Community Care Health Network LLC

  dba Matrix Medical Network

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1740813948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E 15TH ST",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315102908",
            "telephone_number": "912-632-2952",
            "fax_number": "912-632-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016209",
            "telephone_number": "912-490-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNA",
        "middle_name": "HOLLAND",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-15",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN195918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Athena",
            "affiliation": "N",
            "endpointDescription": "Athena",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct, Athena",
            "address_1": "2015 Alice St",
            "city": "Waycross",
            "state": "GA",
            "country_code": "US",
            "postal_code": "315016209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tammy Wiggins, NP
• Jason E Wilkerson
• Donnetta Wilkinson, LPN
• William C Hurst, Sr., D.M.D., P.C.
• William Keith Crummey DMD PC
• Joletha Williams
• Jordan Alysse Williams
• Lakeshia Nichole Williams
• Rhonda Christina Williams, RN
• Rhonda O Williams, MD

• Nurse Practitioner in Waycross, GA
• Providers in Waycross, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.