Carllisa Williams, RN in Jacksonville, FL - Medicare Nurse Practitioner

Carllisa Williams, RN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Jacksonville, Florida. Her current practice location is 856 Poydras Ln W, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 502-4851.

Carllisa Williams is licensed to practice in Florida (license number 11022415) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124515440.

Contact Information

	Carllisa Williams, RN
	856 Poydras Ln W, Jacksonville, FL 32218-7694
	(904) 502-4851
	Not Available

Map and Direction

Provider's Profile

Full Name	Carllisa Williams
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	856 Poydras Ln W, Jacksonville, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1124515440
Provider Enumeration Date: 04/23/2018
Last Update Date: 09/08/2025

Medicare PECOS Information:

PECOS PAC ID: 1052780145
Enrollment ID: I20221213000109

Medical Identifiers

Medical identifiers for Carllisa Williams such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124515440	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	APRN11022415 (Florida)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	11022415 (Florida)	Primary

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. Carllisa Williams allows following entities to bill medicare on her behalf.

Entity Name	Florida Counseling Network Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1821584202 PECOS PAC ID: 0840544789 Enrollment ID: O20181113002093

Entity Name	Patient Focus Physicians Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801407291 PECOS PAC ID: 1557780426 Enrollment ID: O20200925000781

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. Carllisa 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
Carllisa Williams, RN 856 Poydras Ln W, Jacksonville, FL 32218-7694 Ph: (904) 316-5347	Carllisa Williams, RN 856 Poydras Ln W, Jacksonville, FL 32218-7694 Ph: (904) 502-4851

Reviews and Comments

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Carllisa Williams, RN - Medicare Nurse Practitioner in Jacksonville, FL