Individual provider Active NPI

Frederic Lee Williams, ARNP

  • Certified Registered Nurse Anesthetist
  • Orange Park, FL
National Provider Identifier
1821314634
Registry record updated Apr 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3283342 Issued in FL
Practice address
2021 Kingsley Ave
Suite 105
Orange Park, FL 32073-5174
Phone
(904) 276-5400
Fax
(904) 276-5430
NPI assigned
Apr 19, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3283342 FL Primary

Addresses

Primary practice location

2021 Kingsley Ave
Suite 105
Orange Park, FL 32073-5174

Mailing address

2021 Kingsley Ave
Suite 105
Orange Park, FL 32073-5174
Phone (904) 276-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100915000392 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234254178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

611 Zeagler Dr
Palatka, FL 32177-3810
Phone (386) 328-5711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
3283342FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Aug 15, 2016 Accepting new patients
Riverside Anesthesia Services, LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2015 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Aug 15, 2016 Accepting new patients

Locations

7207 Golden Wings Rd
Ste 200
Jacksonville, FL 32244
Phone (904) 389-1014

611 Zeagler Dr
Palatka, FL 32177
Phone (386) 326-8070

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271635200000",
    "number": "1821314634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 KINGSLEY AVE",
            "address_2": "SUITE 105",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735174",
            "telephone_number": "904-276-5400",
            "fax_number": "904-276-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 KINGSLEY AVE",
            "address_2": "SUITE 105",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735174",
            "telephone_number": "904-276-5400",
            "fax_number": "904-276-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "FREDERIC",
        "middle_name": "LEE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-19",
        "last_updated": "2010-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "3283342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.