DERRICK LANE WILLIAMS (NPI# 1922333194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922333194 |
| Entity Type | Individual |
| Full Name | DERRICK LANE WILLIAMS |
| Credential | RN, APRN, ACNP |
| Practice Address |
7950 W Jefferson Blvd Fort Wayne IN 46804-4140 |
| Mailing Address |
10351 Dawsons Creek Blvd Suite A-1 Fort Wayne IN 46825-1904 |
| Practice Telephone | 2602039600 |
| Practice Fax Number | 2607396167 |
| Mailing Telephone | 2602039600 |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2014-09-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71003104A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
28139511A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200972030 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053548339 | Derrick V Williams | Student in an Organized Health Care Education/Training Program | 9500 Euclid Ave # J4-3331, Anes: Anesthesiology, Cleveland, OH 44195-0001 | 2009-06-15 |
| 1881293892 | Derrick Williams | Registered Nurse | 4646 John R St, Detroit, MI 48201-1916 | 2020-10-21 |
| 1306302682 | Derrick Williams | Rehabilitation Practitioner | 2677 Zoe Ave Ste 304, Huntington Park, CA 90255-3699 | 2019-02-12 |
| 1285178889 | Derrick Williams | Community Health Worker | 7733 Forsyth Blvd Fl 11, Clayton, MO 63105-1878 | 2016-12-15 |
| 1144771262 | Derrick Williams | Counselor | 1602 Royal Ave, Monroe, LA 71201-5612 | 2016-10-24 |
| 1457774606 | Derrick Martin Williams | Counselor | 102 Pilling St, Brooklyn, NY 11207-1610 | 2014-01-23 |
| 1942574207 | Derrick Williams | Social Worker | 2302 Parklake Dr Ne, Suite 350, Atlanta, GA 30345-2896 | 2012-03-05 |
| 1780966408 | Derrick H Williams | Family Medicine | 305 Estill St, 4th Floor, Berea, KY 40403-1742 | 2011-09-20 |
| 1366724619 | Derrick Williams | Rehabilitation Practitioner | 3840 N Commerce St, Ste. 200, North Las Vegas, NV 89032-8104 | 2011-09-13 |
| 1518290873 | Derrick Demetrius Williams Sr. | Counselor | 4343 Williamsbourgh Dr, Sacramento, CA 95823-2006 | 2009-09-17 |
| Street Address |
7950 W JEFFERSON BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760486187 | Heather J. Wolfe | Pediatrics | 7950 W Jefferson Blvd, Suite 212, Fort Wayne, IN 46804-4140 | 2005-06-13 |
| 1831798354 | Dorian Raymone Tate | Nurse Anesthetist, Certified Registered | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-10-26 |
| 1528665585 | Alexis Kate Felger | Nurse Practitioner | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-10-02 |
| 1114534054 | Mary Catherine Richter | Specialist/Technologist, Other | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-09-24 |
| 1538778386 | Lori Elizabeth Jackson | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-07-28 |
| 1831708965 | Anna N. Kemler | Nurse Practitioner | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-07-24 |
| 1699383307 | David James Mansfield | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-07-20 |
| 1932726452 | Joseph Egbert | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-06-30 |
| 1245851872 | Lauren Tirey | Occupational Therapist | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-05-05 |
| 1609415421 | Mikhaila Sailor | Dietitian, Registered | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2019-12-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394599 | Laury Farrell | Nurse Practitioner | 6017 Stoney Creek Dr, Fort Wayne, IN 46825-4410 | 2020-10-22 |
| 1730787599 | Crystal Neal | Nurse Practitioner | 4430 Keeneland Ln Unit 202, Fort Wayne, IN 46845-1985 | 2020-10-14 |
| 1225668312 | Kathleen Vanderreyden | Nurse Practitioner | 3005 E State Blvd, Fort Wayne, IN 46805-4736 | 2020-01-17 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1275980690 | April Anderson | Nurse Practitioner | 6920 Pointe Inverness Way Ste 120, Fort Wayne, IN 46804-7926 | 2016-05-16 |
| 1922470970 | Jennifer Carol Littke | Nurse Practitioner | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 | 2015-10-28 |
| 1275956054 | Andrea N Lahrman | Nurse Practitioner | 11123 Parkview Plaza Dr Ste 106, Fort Wayne, IN 46845-1707 | 2014-01-29 |
| 1417213729 | Laura Beth Baker | Nurse Practitioner | 5750 Falls Drive, Fort Wayne, IN 46804-7147 | 2012-04-11 |
| 1447572441 | Kathryn L Smith | Nurse Practitioner | 11104 Parkview Circle Dr Ste 20, Fort Wayne, IN 46845-1733 | 2010-02-18 |
| 1316180144 | Braden M Butterfield Mckinley | Nurse Practitioner | 2101 E Coliseum Blvd Rm 234, Fort Wayne, IN 46805-1445 | 2009-04-09 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on DERRICK LANE WILLIAMS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.