Individual provider Active NPI

Gwendolyn Patrice Williams, APRN

  • Family Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1790624823
Registry record updated Oct 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11045892 Issued in FL
Practice address
695 N Clyde Morris Blvd
Daytona Beach, FL 32114-2321
Phone
(386) 334-6893
Fax
(386) 334-6893
NPI assigned
Mar 25, 2026
Last updated
Oct 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2026

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 APRN11045892 FL Primary

Addresses

Primary practice location

695 N Clyde Morris Blvd
Daytona Beach, FL 32114-2321

Mailing address

1667 N Clyde Morris Blvd Ste 2
Daytona Beach, FL 32117-5500
Phone (386) 274-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP11045892FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vera Endocrine Associates Inc PastSince May 19, 2015 Accepting new patients
Lakeside Endocrine Associates, Inc PastSince Nov 1, 2016 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12862/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1774396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792454400000",
    "number": "1790624823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1667 N CLYDE MORRIS BLVD STE 2",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175500",
            "telephone_number": "386-274-1414",
            "fax_number": "386-274-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142321",
            "telephone_number": "386-334-6893",
            "fax_number": "386-334-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "GWENDOLYN",
        "middle_name": "PATRICE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-10-20",
        "certification_date": "2026-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11045892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.