Individual provider Active NPI

Nichole Lasha Williams, FNP

  • Family Nurse Practitioner
  • Waldorf, MD
National Provider Identifier
1750852554
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22529 Issued in SC
Practice address
3460 Old Washington Rd Ste 203a
Waldorf, MD 20602-3243
Phone
(301) 638-9670
NPI assigned
Dec 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 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 22529 SC Primary

Addresses

Primary practice location

3460 Old Washington Rd Ste 203a
Waldorf, MD 20602-3243

Mailing address

9612 Stuart LN
Clinton, MD 20735-3376
Phone (843) 260-2748

Other practice location 1

12070 Old Line Ctr Ste 303
Waldorf, MD 20602-3535
Phone (301) 645-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, MD, DC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190912000074 SC Practitioner - Nurse Practitioner 1456680750 Reassigns benefits to 2 organizations
I20230711003588 MD Practitioner - Nurse Practitioner 1456680750 Reassigns benefits to 3 organizations
I20250516000381 DC Practitioner - Nurse Practitioner 1456680750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
M Medical Group, Inc.Group PAC ID 7719278597, 104 clinicians
Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians
Mdics at Civista LLCGroup PAC ID 8325200793, 35 clinicians

Practice addresses (Care Compare)

1051 Brightseat Rd
Hyattsville, MD 20785-3738
Phone (240) 487-4400

15364 Prince Frederick Rd
Unit B
Hughesville, MD 20637-3176
Phone (410) 224-2255

5 Garrett Ave
La Plata, MD 20646-5960
Phone (443) 949-0814

9106 Pine View LN
Clinton, MD 20735-3229
Phone (301) 865-2930

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.92 of 100Reported as group
Quality
82
Improvement activities
40
Cost
67.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22529SCMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mdics at Civista LLC CurrentSince May 26, 2023 Accepting new patients
Privia Care Center LLC Current Accepting new patients
M Medical Group, Inc. CurrentSince Mar 17, 2025 Accepting new patients
Privia Care Center LLC CurrentSince Sep 4, 2025 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Pelham Medical Center CurrentSince Apr 12, 2021 Accepting new patients
Menocal Medical Services PA Current Accepting new patients
Spartanburg Medical Center CurrentSince Apr 12, 2021 Accepting new patients
Pelham Medical Center CurrentSince Apr 12, 2021 Accepting new patients
Spartanburg Medical Center CurrentSince Apr 12, 2021 Accepting new patients
M Medical Group, Inc. CurrentSince Mar 17, 2025 Accepting new patients
Careway Southern Maryland Clinic LLC Past Accepting new patients
Pediatrix Medical Group of the Mid-Atlantic PC PastSince Jun 4, 2023 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

9106 Pine View Ln
Clinton, MD 20735
Phone (301) 856-2930

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000

250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nwilliams923934@direct.umm.edu
  • Direct secure messaging: nichole.williams.1@8042.direct.athenahealth.com

Organizations & group practices 16

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.

View all 16

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": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1750852554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9612 STUART LN",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353376",
            "telephone_number": "843-260-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 OLD WASHINGTON RD STE 203A",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023243",
            "telephone_number": "301-638-9670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12070 Old Line Ctr Ste 303",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206023535",
            "country_code": "US",
            "telephone_number": "301-645-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "NICHOLE",
        "middle_name": "LASHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "22529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.