Individual provider Active NPI

Demetre Deline Williams, FNP-BC

  • Family Nurse Practitioner
  • Florissant, MO
National Provider Identifier
1821704974
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023006453 Issued in MO
Practice address
2330 N Highway 67
Florissant, MO 63033-2034
Phone
(314) 594-3618
NPI assigned
Jan 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 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 2023006453 MO Primary

Addresses

Primary practice location

2330 N Highway 67
Florissant, MO 63033-2034

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (888) 987-1151

Other practice location 1

11642 W Florissant Ave
Florissant, MO 63033-6723
Phone (314) 838-8220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230331000224 MO Practitioner - Nurse Practitioner 3678948882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archwell Health Professional Services of Kansas PAGroup PAC ID 4688072358, 25 clinicians

Practice addresses (Care Compare)

2330 N Hwy 67
Florissant, MO 63033-2034
Phone (314) 584-3618

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Archwell Health Professional Services of Kansas, P.a. CurrentSince Aug 19, 2025 Accepting new patients
Betty Jean Kerr People'S Health Centers CurrentSince Jul 10, 2023 Accepting new patients
Betty Jean Kerr People'S Health Centers CurrentSince Jul 10, 2023 Accepting new patients

Locations

199 N Florissant Rd
Ferguson, MO 63135
Phone (314) 449-9640

11642 West Florissant Ave
Florissant, MO 63033
Phone (314) 830-4713

2330 N Highway 67
Florissant, MO 63033
Phone (314) 584-3618

11605 E 23rd St S
Independence, MO 64050
Phone (816) 579-6891

5701 Delmar Blvd
Saint Louis, MO 63112
Phone 31436778481248

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Interoperability endpoints

  • Direct secure messaging: demetre.williams.p1@direct.phcenters.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1821704974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "888-987-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 N HIGHWAY 67",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630332034",
            "telephone_number": "314-594-3618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11642 W Florissant Ave",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630336723",
            "country_code": "US",
            "telephone_number": "314-838-8220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DEMETRE",
        "middle_name": "DELINE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023006453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

Verify at the official NPI Registry.