Individual provider Active NPI

Renee Denise Williams, APRN

  • Nurse Practitioner
  • Bella Vista, AR
National Provider Identifier
1962877852
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A004668 Issued in AR
Practice address
1 Mercy Way
Bella Vista, AR 72714-3000
Phone
(479) 802-5555
Fax
(479) 876-2829
NPI assigned
Dec 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A004668 AR Primary

Addresses

Primary practice location

1 Mercy Way
Bella Vista, AR 72714-3000

Mailing address

1 Mercy Way
Bella Vista, AR 72714-3000
Phone (479) 802-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20160421000446 AR Practitioner - Nurse Practitioner 2264730415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, 314 clinicians

Practice addresses (Care Compare)

1 Mercy Way
Bella Vista, AR 72714-3000
Phone (479) 802-5555

3101 SE 14TH St
Bentonville, AR 72712-4900
Phone (479) 631-2100

Hospital & facility affiliations

  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A004668ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities CurrentSince Feb 29, 2016 Accepting new patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Feb 29, 2016 Accepting new patients

Locations

1 Mercy Way
Bella Vista, AR 72714
Phone (479) 802-5555

1 Mercy Way
Ste 30
Bella Vista, AR 72714
Phone (479) 636-9234

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

Interoperability endpoints

  • Direct secure messaging: rwilliams275528@directc.mercy.net

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 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": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1962877852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MERCY WAY",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727143000",
            "telephone_number": "479-802-5555",
            "fax_number": "479-876-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCY WAY",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727143000",
            "telephone_number": "479-802-5555",
            "fax_number": "479-876-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RENEE",
        "middle_name": "DENISE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-03",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A004668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bella Vista, AR

Sources for this page

Verify at the official NPI Registry.