KIMBERLY SUE WILLIAMS (FNP) – Family Nurse Practitioner, NPI 1578870069

KIMBERLY SUE WILLIAMS (FNP) is a healthcare provider. based in Portland, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. NP19924 (CA). The NPI Number for KIMBERLY SUE WILLIAMS (FNP) is 1578870069

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLY SUE WILLIAMS (FNP)
NPI
1578870069
Phone
Not provided
Address
PO BOX 3158
Enumeration Date
7 September 2010
Last Update Date
25 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5032156405
Graduation Year
2010 (16 years ago)
PAC ID
3476781055
Group Practice PAC ID
0648183608
Professional Enrollment ID
I20140417002086
Address ID
OR972132984PO5050XSTXX407

Contacts

Secure Messaging
kwilliams419403@oc.providencedirect.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness85
Years active:15State licenses:2Other namesUpdated within 12 months

3,379 NURSE PRACTITIONER in OR

Provider Addresses for KIMBERLY SUE WILLIAMS (FNP)

  • PO BOX 3158

    PORTLAND, OR 972083158

    Phone:

    Type: Mailing

  • 18040 SW LOWER BOONES FERRY RD

    SUITE 100

    TIGARD, OR 972247258

    Phone: (503) 216-0700

    Fax: (503) 216-0750

    Type: Location

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: 2014-04-17

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
I20140417002086INurse PractitionerORTBD

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 minutes4140$0
99214Established patient office or other outpatient visit, 30-39 minutes3433$0
View full utilization report →

Insurance plans in this area (ZIP 97208)

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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: 0648183608View full group profile
NameSpecialtyState
Internal MedicineOR
Physician AssistantOR
-OR
N E U R O L O G YOR
Nurse PractitionerOR
Infectious Disease, Internal MedicineOR
Thoracic SurgeryOR
Nurse PractitionerOR
Physician AssistantWA
Clinical PsychologistOR

Reviews

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Frequently asked questions

What NPI should I save for KIMBERLY SUE WILLIAMS (FNP)?
Save NPI 1578870069 if you need a stable reference for KIMBERLY SUE WILLIAMS (FNP).
Is KIMBERLY SUE WILLIAMS (FNP) currently active in the NPI registry?
CMS-published data lists KIMBERLY SUE WILLIAMS (FNP) as an active registrant.
Does KIMBERLY SUE WILLIAMS (FNP) list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for KIMBERLY SUE WILLIAMS (FNP). Clinical services aligned with this taxonomy classification.
What location metadata exists for KIMBERLY SUE WILLIAMS (FNP)?
The page summarizes Portland, Oregon for KIMBERLY SUE WILLIAMS (FNP); expand the address list for detail.
How can I contact KIMBERLY SUE WILLIAMS (FNP)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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