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BLAKE MCCULLOUGH WILLIAMS FNP
NPI 1396363438
Nurse Practitioner - Primary Care in Columbus, OH

Active since July 06, 2020PECOS Enrolled
4200 REGENT ST STE 200, COLUMBUS, OH 43219(877) 870-1775(614) 968-8840 Get Directions Write a Review

NPPES record last updated: December 1, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 1, 2025, Jul 6, 2020 (2 updates tracked since 2020).

About Blake Mccullough Williams Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLAKE MCCULLOUGH WILLIAMS FNP (NPI 1396363438) is an individual primary care provider in Columbus, Ohio, licensed in Louisiana (214331) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396363438
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameBLAKE MCCULLOUGH WILLIAMSCredential: FNP
Location Address4200 REGENT ST STE 200Columbus, OH 43219-6229
Mailing Address435 Williams Hill RdPitkin, LA 70656-5762 · (318) 308-4063
Phone(877) 870-1775
Fax(614) 968-8840
Sole ProprietorNo
Enumeration DateJuly 6, 2020
Last NPPES UpdateDecember 1, 20252 updates tracked since enumeration
NPPES CertifiedDecember 1, 2025
✔ NPI 1396363438 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in LA · 214331
4200 REGENT ST STE 200, Columbus, OH 43219
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blake Mccullough Williams Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Blake Williams reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Brighton Bridge Hospice LLC
855 mi
Hospice Care, Community Based
213 NORTH FIRST ST, B
Oberlin, LA 70655
  • Reassigned Medicare billing, Louisiana enrollment
NPI 1629007794 (337) 639-9200
Calcasieu Urgent Care LLC
897 mi
Urgent Care
2640 COUNTRY CLUB RD, SUITE 400
Lake Charles, LA 70605
  • Reassigned Medicare billing, Louisiana enrollment
  • 314 clinicians in this Medicare group
NPI 1467715490 (931) 253-1110

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43219 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER NICKENS FNP-C
Nurse Practitioner (Family)
4200 REGENT ST STE 200
COLUMBUS, OH 43219
Franklin County (248) 780-0050
DANNI LYNNETTE HENDERSON AGNP-C
Nurse Practitioner (Adult Health)
4200 REGENT ST STE 200
COLUMBUS, OH 43219
Franklin County (877) 870-1775
DARIO PETKOVIC PT
Physical Therapist
4200 REGENT ST STE 200
COLUMBUS, OH 43219
Franklin County (866) 839-6979
CONNIE THACH DNP, FNP-BC
Nurse Practitioner
4200 REGENT ST STE 200
COLUMBUS, OH 43219
Franklin County (877) 581-2210
KATELYN ELAINE DYE APRN
Nurse Practitioner (Primary Care)
4200 REGENT ST STE 200
COLUMBUS, OH 43219
Franklin County (843) 709-0739
VALERIE CLARK FNP
Nurse Practitioner (Family)
4200 REGENT ST STE 200
COLUMBUS, OH 43219
Franklin County (877) 581-2210
JENNIFER M. KUCK
Dietitian, Registered
4200 REGENT ST STE 200
COLUMBUS, OH 43219
Franklin County (614) 944-5123
LATASHA ROSHELLE EVANS FNP
Nurse Practitioner (Family)
4200 REGENT ST STE 200
COLUMBUS, OH 43219
Franklin County (877) 870-1775

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blake Williams's NPI number?

The NPI number for Blake Williams is 1396363438. It was assigned to this individual provider in the NPPES registry on July 6, 2020.

Where is Blake Williams located?

Blake Williams practices at 4200 Regent St Ste 200, Columbus, OH 43219. The listed phone number is (877) 870-1775.

What is Blake Williams's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Blake Williams enrolled in Medicare?

Yes. Blake Williams is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Blake Williams's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Blake Williams reassigns Medicare benefits to 2 organizations: Brighton Bridge Hospice LLC (Oberlin, LA) and Calcasieu Urgent Care LLC (Lake Charles, LA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Blake Williams's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Blake Williams was last updated on December 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.