TISA MARIE WILLIAMS
NPI 1649964107
Nurse Practitioner - Gerontology in Louisville, KY

Active since June 07, 2023PECOS EnrolledAccepts Medicare Assignment
3999 DUTCHMANS LN STE 7B, LOUISVILLE, KY 40207(502) 896-4791 Get Directions Write a Review

NPPES record last updated: August 26, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 19, 2024, Jun 7, 2023 (2 updates tracked since 2023).

About Tisa Marie Williams NPPES

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

TISA MARIE WILLIAMS (NPI 1649964107) is an individual gerontology provider in Louisville, Kentucky, licensed in Kentucky (4036265) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS, is affiliated with Norton Hospitals, Inc, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1649964107
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameTISA MARIE WILLIAMS
Location Address3999 DUTCHMANS LN STE 7BLouisville, KY 40207-4742
Mailing AddressPo Box 776351Chicago, IL 60677-6351 · (502) 559-9425 · Fax (502) 272-5339
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJune 7, 2023
Last NPPES UpdateAugust 26, 20252 updates tracked since enumeration
NPPES CertifiedAugust 26, 2025
NPI 1649964107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
Licenses Licensed in KY · 4036265 Licensed in OH · APRN.CNP.0033951
3999 DUTCHMANS LN STE 7B, Louisville, KY 40207

Secondary Practice Locations 2

Location 13315 Bexley DrMiddletown, OH 45042-2570 · Phone (937) 204-4043
Location 23700 Southern Blvd Ste 300Kettering, OH 45429-1265 · Phone (937) 643-9299 · Fax (937) 643-2343

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Tisa Marie Williams is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6709224322
PECOS Enrollment IDI20240402002238, I20251023003409
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180088
Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County
Emergency services Birthing friendly

Kettering Health Main Campus

Acute Care Hospitals · Kettering, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360079
Location3535 Southern BoulevardKettering, OH 45429 · Montgomery County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40207 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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 11

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

Internal Medicine (Gastroenterology)
3999 DUTCHMANS LN STE 7B
LOUISVILLE, KY 40207
Physician Assistant
3999 DUTCHMANS LN STE 7B
LOUISVILLE, KY 40207
Internal Medicine (Gastroenterology)
3999 DUTCHMANS LN STE 7B
LOUISVILLE, KY 40207
Nurse Practitioner (Family)
3999 DUTCHMANS LN STE 7B
LOUISVILLE, KY 40207
Physician Assistant
3999 DUTCHMANS LN STE 7B
LOUISVILLE, KY 40207
Nurse Practitioner (Family)
3999 DUTCHMANS LN STE 7B
LOUISVILLE, KY 40207
Internal Medicine (Gastroenterology)
3999 DUTCHMANS LN STE 7B
LOUISVILLE, KY 40207
Nurse Practitioner (Family)
3999 DUTCHMANS LN STE 7B
LOUISVILLE, KY 40207

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 Tisa Williams's NPI number?

The NPI number for Tisa Williams is 1649964107. It was assigned to this individual provider in the NPPES registry on June 7, 2023.

Where is Tisa Williams located?

Tisa Williams practices at 3999 Dutchmans Ln Ste 7B, Louisville, KY 40207. The listed phone number is (502) 896-4791.

What is Tisa Williams's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Tisa Williams enrolled in Medicare?

Yes. Tisa Williams is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Tisa Williams accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 2 other insurers list Tisa Williams as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Tisa Williams affiliated with any hospitals?

According to CMS data, Tisa Williams is affiliated with Norton Hospitals, Inc and Kettering Health Main Campus.

When was this NPI record last updated?

The NPPES record for Tisa Williams was last updated on August 26, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.