Derrick Williams, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005948 Issued in GA

Practice address

2302 Parklake Dr NE
Suite 350
Atlanta, GA 30345-2896

Phone

(770) 621-0469

NPI assigned

Mar 5, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derrick.williams.1@9679.direct.athenahealth.com

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.

• Medcura Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Stone Mountain, GA
  • NPI 1417011487
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, GA

  Medicare reassignment NPD
• Medcura Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1811761448
  NPD
• Medcura Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Decatur, GA
  • NPI 1245010347
  NPD (past)
• Transitional Family Sevices

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1972946218
  NPD (past)

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1942574207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 PARKLAKE DR NE",
            "address_2": "SUITE 350",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452896",
            "telephone_number": "770-621-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 PARKLAKE DR NE",
            "address_2": "SUITE 350",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452896",
            "telephone_number": "770-621-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "DERRICK",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-05",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "005948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1745 Peachtree St NE Ste U",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303092479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David M Williams, M.D.
• David P Williams, M.D.
• Deanna Grace Williams, BSW, S/T
• Deborah Darlene Williams, APRN, BC, CNP
• Denise Williams
• Destin Williams
• Devan Tenner Williams
• Deyuan Antwon Williams
• Dmora Williams, RN
• Dnyce L Williams, MD

• Clinical Social Worker in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.