DEREK LEE SCOTT WILLIAMS (APRN) – Family Nurse Practitioner, NPI 1043896301

DEREK LEE SCOTT WILLIAMS (APRN) is a healthcare provider. based in Springfield, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 2021013081 (MO). The NPI Number for DEREK LEE SCOTT WILLIAMS (APRN) is 1043896301

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
DEREK LEE SCOTT WILLIAMS (APRN)
NPI
1043896301
Phone
(417) 832-1117
Address
1308 N Glenstone Ave
Enumeration Date
18 March 2021
Last Update Date
18 April 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4179861289
Graduation Year
2020 (6 years ago)
PAC ID
5890182059
Group Practice PAC ID
5193089621
Professional Enrollment ID
I20220419000724
Address ID
MO658075208SP900XXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

7,017 NURSE PRACTITIONER in MO

Provider Addresses for DEREK LEE SCOTT WILLIAMS (APRN)

  • 1308 N Glenstone Ave

    Springfield, MO 658022130

    Phone: (417) 832-1117

    Type: Location

  • 3233 E SUNSHINE ST STE 100

    SPRINGFIELD, MO 658042106

    Phone: (417) 812-8149

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-04-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220419000724INurse PractitionerMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes207174$0
99203New patient office or other outpatient visit, 30-44 minutes140140$0
87811Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)5150$0
81003Automated urinalysis test4443$0
87804Detection test by immunoassay with direct visual observation for influenza virus2716$0
View full utilization report →

Insurance plans in this area (ZIP 65802)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5193089621View full group profile
NameSpecialtyState
Nurse PractitionerMO
Physician AssistantMO
Osteopathic Manipulative Medicine, Family PracticeKS
Family PracticeMO
Nurse PractitionerMO
Family PracticeMO
Family PracticeMO
Family PracticeMO
Emergency MedicineOH
Family PracticeNC

Reviews

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Frequently asked questions

How do I look up DEREK LEE SCOTT WILLIAMS (APRN) by NPI?
Use NPI 1043896301 when you need to reference DEREK LEE SCOTT WILLIAMS (APRN) in forms, claims, or directories.
Is DEREK LEE SCOTT WILLIAMS (APRN) active in the national directory?
DEREK LEE SCOTT WILLIAMS (APRN)'s public NPI profile is in an active state.
What field does DEREK LEE SCOTT WILLIAMS (APRN) work in?
You can think of DEREK LEE SCOTT WILLIAMS (APRN) as practicing within Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is DEREK LEE SCOTT WILLIAMS (APRN)'s primary listing?
We display Springfield, Missouri because that is what the record indicates for DEREK LEE SCOTT WILLIAMS (APRN).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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