Individual provider Active NPI

Jennifer Lee Williams, APRN

  • Nurse Practitioner
  • Longview, TX
National Provider Identifier
1801519426
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1094702 Issued in TX
Practice address
707 E Marshall Ave
Longview, TX 75601-5545
Phone
(903) 315-4880
NPI assigned
Sep 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1094702 TX
Nurse Practitioner 363L00000X 1094702 TX Primary

Addresses

Primary practice location

707 E Marshall Ave
Longview, TX 75601-5545

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 606-6400

Other practice location 1

705 E Marshall Ave
Longview, TX 75601-5573
Phone (903) 315-2000

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
I20221128001123 TX Practitioner - Nurse Practitioner 9133597032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

105 Zeid Blvd
Henderson, TX 75652-6070
Phone (903) 595-2283

1600 Broadway Ave
Gladewater, TX 75647-5040
Phone (903) 315-5630

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

700 E Marshall Ave
Christus Trinity Clinic
Longview, TX 75601-5580
Phone (903) 315-1488

707 E Marshall Ave
Longview, TX 75601-5545
Phone (903) 595-2283

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Nov 20, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Nov 20, 2022 Accepting new patients

Locations

707 E Marshall Ave
Longview, TX 75601
Phone (903) 315-4880

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: jwilliams248478@christushealth.direct-ci.net

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.

Hospital & facility affiliations 1

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": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1801519426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-606-6400",
            "fax_number": "903-606-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015545",
            "telephone_number": "903-315-4880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015573",
            "country_code": "US",
            "telephone_number": "903-315-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1094702",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1094702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.