NPIMap

Individual provider Active NPI

Tina Joanne Williamson, FNP-C

  • Family Nurse Practitioner
  • Albany, OR
National Provider Identifier
1932389194
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202111413NP-PP Issued in OR
Practice address
832 Elm St
Suite 101
Albany, OR 97321
Phone
(541) 812-5820
Fax
(541) 812-5821
NPI assigned
Nov 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 200241926RN OR
Family Nurse Practitioner 363LF0000X 202111413NP-PP OR Primary

Addresses

Primary practice location

832 Elm St
Suite 101
Albany, OR 97321

Mailing address

PO Box 1188
Corvallis, OR 97339-1188

Other identifiers 1

IdentifierTypeStateIssuer
202111413NP-PPOtherORNURSE PRACTITIONER LICENSURE - OSBN

Other names 1

  • Ms. Tina Copple Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address twilliamson6109@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211029002237 OR Practitioner - Nurse Practitioner 9133517857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany General HospitalGroup PAC ID 9931097987, 191 clinicians

Practice addresses (Care Compare)

1046 6TH Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000

705 Elm St SW
Suite 200
Albany, OR 97321-1957
Phone (541) 812-4850

832 Elm St SW
Albany, OR 97321-2062

Hospital & facility affiliations

  • Samaritan Albany General Hospital Hospital, Albany, OR, CCN 380022

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
92.31
Promoting interoperability
100
Improvement activities
40
Cost
80.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200241926RNORMDMedical-Surgical Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital CurrentSince Oct 20, 2021 Accepting new patients
Albany General Hospital Current Accepting new patients
Albany General Hospital CurrentSince Oct 20, 2021 Accepting new patients

Locations

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

832 Elm St SW
Ste 101
Albany, OR 97321
Phone (541) 812-5820

1046 6th Ave SW
Albany, OR 97321
Phone (541) 812-4000

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 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1932389194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1188",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 ELM ST",
            "address_2": "SUITE 101",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "97321",
            "telephone_number": "541-812-5820",
            "fax_number": "541-812-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "TINA",
        "middle_name": "JOANNE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-05",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "OR",
            "license": "200241926RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202111413NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSURE - OSBN",
            "identifier": "202111413NP-PP",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twilliamson6109@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "832 Elm St",
            "address_2": "Suite 101",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "COPPLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.