Individual provider Active NPI

Fannie Laura Williams, NP

  • Adult Health Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1922383264
Registry record updated Nov 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
COA.12676-NP Issued in OH
Practice address
8300 Hough Ave
Cleveland, OH 44103-4247
Phone
(216) 231-7700
Fax
(216) 231-7920
NPI assigned
Oct 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X COA.12676-NP OH Primary

Addresses

Primary practice location

8300 Hough Ave
Cleveland, OH 44103-4247

Mailing address

8300 Hough Ave
Cleveland, OH 44103-4247
Phone (216) 231-7700

Other identifiers 1

IdentifierTypeStateIssuer
0055717MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120815000640 OH Practitioner - Nurse Practitioner 0941456479 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians

Practice addresses (Care Compare)

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.12676-NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Current Accepting new patients
Northeast Ohio Neighborhood Health Services, Inc. CurrentSince Jun 16, 2015 Accepting new patients
The Metrohealth System CurrentSince Apr 6, 2016 Accepting new patients
The Metrohealth System CurrentSince Apr 6, 2016 Accepting new patients
Northeast Ohio Neighborhood Health Services, Inc. Current Accepting new patients
Northeast Ohio Neighborhood Health Services, Inc. CurrentSince Jun 16, 2015 Accepting new patients
Northeast Ohio Neighborhood Health Services, Inc. Past Accepting new patients

Locations

8300 Hough Ave
Cleveland, OH 44103
Phone (216) 231-7700

4229 Pearl Rd
Cleveland, OH 44109
Phone (216) 459-6300

15322 Saint Clair Ave
Cleveland, OH 44110
Phone (216) 491-2318

4800 Payne Ave
Cleveland, OH 44103
Phone (216) 231-7700

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

Interoperability endpoints

  • Direct secure messaging: fannie.williamsanp.p1@direct.neon.nextgenshare.com
  • Direct secure messaging: fwilliams91924@direct.metrohealth.org

Organizations & group practices 7

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 2

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": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448064000000",
    "number": "1922383264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 HOUGH AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441034247",
            "telephone_number": "216-231-7700",
            "fax_number": "216-231-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 HOUGH AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441034247",
            "telephone_number": "216-231-7700",
            "fax_number": "216-231-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "FANNIE",
        "middle_name": "LAURA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2015-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.12676-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0055717",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.