Individual provider Active NPI

Aimee Elizabeth Williamson, APRN

  • Pediatric Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1982243721
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4012335 Issued in KY
Practice address
740 S Limestone
Lexington, KY 40536-1003
Phone
(859) 323-5661
Fax
(859) 323-6411
NPI assigned
Dec 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2018002345 MO
Pediatric Nurse Practitioner 363LP0200X 4012335 KY Primary

Addresses

Primary practice location

740 S Limestone
Lexington, KY 40536-1003

Mailing address

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 268-4110

Other practice location 1

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 268-4110

Other names 1

  • Aimee Elizabeth Roddy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200420001289 MO Practitioner - Nurse Practitioner 8921438763 Reassigns benefits to 1 organization
I20240416000931 KY Practitioner - Nurse Practitioner 8921438763 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018002345MOMDPediatrics Physician
4012335KYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Cardinal Glennon Children'S Hospital Pediatrics CurrentSince Mar 14, 2020 Accepting new patients
University of Kentucky CurrentSince Mar 29, 2024 Accepting new patients
SSM Cardinal Glennon Childrens Hospital Pediatrics CurrentSince Mar 14, 2020 Accepting new patients
SSM Cardinal Glennon Childrens Hospital Pediatrics Current Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189

3878 Pershall Rd
Saint Louis, MO 63135
Phone (314) 344-6021

Interoperability endpoints

  • Direct secure messaging: aroddy339038@ukhcdirect.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1982243721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-268-4110",
            "fax_number": "314-268-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405361003",
            "telephone_number": "859-323-5661",
            "fax_number": "859-323-6411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1465 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041003",
            "country_code": "US",
            "telephone_number": "314-268-4110",
            "fax_number": "314-268-4130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "AIMEE",
        "middle_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-26",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2018002345",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "4012335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AIMEE",
            "last_name": "RODDY",
            "middle_name": "ELIZABETH",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.