Kimberly Sue Williams, FNP is a medicare enrolled "Nurse Practitioner - Family" physician in Tigard, Oregon. She graduated from medical school in 2010 and has 14 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Providence Health And Services Oregon and her current practice location is
18040 Sw Lower Boones Ferry Rd, Suite 100, Tigard, Oregon. You can reach out to her office (for appointments etc.) via phone at
(503) 216-0700.
Kimberly Sue Williams is licensed to practice in Oregon (license number 201393029NP-PP) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1578870069.
Physician's Profile
Full Name | Kimberly Sue Williams |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Experience | 14 Years |
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Location | 18040 Sw Lower Boones Ferry Rd, Tigard, Oregon |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Kimberly Sue Williams graduated from medical school in 2010
NPI Data:
- NPI Number: 1578870069
- Provider Enumeration Date: 09/07/2010
- Last Update Date: 03/25/2021
Medicare PECOS Information:
- PECOS PAC ID: 3476781055
- Enrollment ID: I20140417002086
Medical Identifiers
Medical identifiers for Kimberly Sue Williams such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1578870069 | NPI | - | NPPES |
P01404411 | Other | OR | RR MEDICARE - PH&S |
NP19924 | Other | CA | CA. BOARD OF NURSING |
500667975 | Medicaid | OR | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207V00000X | Obstetrics & Gynecology | NP19924 (California) | Secondary |
208000000X | Pediatrics | NP19924 (California) | Secondary |
363L00000X | Nurse Practitioner | NP19924 (California) | Secondary |
363LF0000X | Nurse Practitioner - Family | 201393029NP-PP (Oregon) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Providence Health And Services Oregon | 0648183608 | 1344 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberly Sue Williams allows following entities to bill medicare on her behalf.
Entity Name | Providence Health & Services Oregon |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1023488343 PECOS PAC ID: 0648183608 Enrollment ID: O20031106000652 |
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Entity Name | Providence Health & Services Oregon |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1114015971 PECOS PAC ID: 9335057447 Enrollment ID: O20031117000153 |
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Entity Name | Emergency Medical Associates Of Mcminnville |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1629022876 PECOS PAC ID: 3870585920 Enrollment ID: O20040331000355 |
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Entity Name | Express Care Or Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1205499126 PECOS PAC ID: 1254768732 Enrollment ID: O20200311001372 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Sue Williams is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kimberly Sue Williams, FNP Po Box 3158, Portland, OR 97208-3158 Ph: () - | Kimberly Sue Williams, FNP 18040 Sw Lower Boones Ferry Rd, Suite 100, Tigard, OR 97224-7258 Ph: (503) 216-0700 |
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