Genova L Williams, APRN, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Bradley, Arkansas. Her current practice location is
409 Woodruff St, Bradley, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(870) 330-6060.
Genova L Williams is licensed to practice in Texas (license number AP136038) 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 1770041691.
Provider's Profile
| Full Name | Genova L Williams |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 409 Woodruff St, Bradley, Arkansas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1770041691
- Provider Enumeration Date: 03/10/2019
- Last Update Date: 04/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 0648513796
- Enrollment ID: I20190514000458
Medical Identifiers
Medical identifiers for Genova L Williams such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770041691 | NPI | - | NPPES |
| F11170086 | Other | | AANP FNP CERTIFICATION NUMBER |
| 803397 | Other | TX | RN LICENSE NUMBER |
| AP136038 | Other | TX | APRN LICENSE NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | AP136038 (Texas) | 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. Genova L Williams allows following entities to bill medicare on her behalf.
| Entity Name | Elizabeth Breedlove Family Practice & Aesthetics Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356740054
PECOS PAC ID: 9335293380
Enrollment ID: O20090811000270 |
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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. Genova L 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 |
|---|
Genova L Williams, APRN, FNP-C
4196 Highway 62 412 Ste A,
Hardy, AR 72542-8002
Ph: () - | Genova L Williams, APRN, FNP-C
409 Woodruff St,
Bradley, AR 71826-8715
Ph: (870) 330-6060 |
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