Individual provider Active NPI

Lloyd Lee Williams, FNP-C

  • Family Nurse Practitioner
  • Tucumcari, NM
National Provider Identifier
1851072524
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
74922 Issued in NM
Practice address
402 E Miel de Luna Ave
Tucumcari, NM 88401-3828
Phone
(575) 461-7100
NPI assigned
Jul 26, 2023
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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 74922 NM Primary

Addresses

Primary practice location

402 E Miel de Luna Ave
Tucumcari, NM 88401-3828

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770

Other identifiers 1

IdentifierTypeStateIssuer
01503715MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20231025000660 NM Practitioner - Nurse Practitioner 1052767290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clovis Family Urgent Care LLCGroup PAC ID 4284095324, 9 clinicians

Practice addresses (Care Compare)

1620 S Ave E
Suite D
Portales, NM 88130-7245
Phone (575) 226-4455

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74922NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Current Accepting new patients
Presbyterian Healthcare Services CurrentSince Dec 4, 2023 Accepting new patients

Locations

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

402 E Miel de Luna Ave
Tucumcari, NM 88401
Phone (575) 461-1660

Interoperability endpoints

  • Direct secure messaging: lwilliams48695@direct.phs.org

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

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": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1851072524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E MIEL DE LUNA AVE",
            "city": "TUCUMCARI",
            "state": "NM",
            "postal_code": "884013828",
            "telephone_number": "575-461-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LLOYD",
        "middle_name": "LEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "74922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01503715",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucumcari, NM

Sources for this page

Verify at the official NPI Registry.