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Active NPI 1922333194 Individual Practitioner Male Practitioner

Derrick Lane Williams , RN, APRN, ACNP

Nurse Practitioner • Fort Wayne, IN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Derrick Williams, RN, APRN, ACNP is a certified Nurse Practitioner practicing in Fort Wayne, IN. With approximately 17 years of clinical experience since completing medical education in 2009, Derrick Williams delivers high-quality medical care to the local community at 7950 W JEFFERSON BLVD.

Derrick Williams is affiliated with Marion General Hospital and accepts Medicare assignment.

Frequently performed procedures and clinical services include emergency department visit for life threatening or functioning severity, emergency department visit with low level of medical decision making, emergency department visit with moderate level of medical decision making. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

7950 W Jefferson Blvd

Fort Wayne, IN 468044140

Telephone 2602039600
Fax 2607396167
Associated Practice Facility / Clinic
🏢 Iom Health System Lp Facility NPI 1306897335

Medicare Profile & Education

Medical School

Other

Graduation Year

2009

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Fort Wayne, IN

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
17 Yrs +7.8 yrs vs City Avg
City Avg: 9.2 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
526 Specialists

Practicing in Fort Wayne, IN (2620 Statewide)

Telehealth Adoption Rate
23.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
48.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Williams (17 Years) 17 Yrs
Fort Wayne Specialty Average (9.2 Years) 9.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity
73 71 $275.00 $137.64
99283 Emergency department visit with low level of medical decision making
72 69 $104.00 $55.46
99284 Emergency department visit with moderate level of medical decision making
69 68 $184.00 $94.85
99291 Critical care, first 30-74 minutes
22 22 $328.00 $167.52

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License IN 71003104A

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Nurse Practitioner - Acute Care

NUCC Taxonomy Code: 363LA2100X

State License IN 28139511A

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
200972030 (IN)

Hospital & Practice Group Affiliations

Marion General Hospital

1130 N Baldwin Ave, Marion, IN 469522536

Phone: 7656607480

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

20 Associated Practitioners
Dr. Albert Emilian , MD

Emergency Medicine

NPI 1033142542

Doctor of Medicine (M.D.)

Dr. Whitney Miller , DO

Emergency Medicine

NPI 1073939450

Doctor of Osteopathic Medicine (D.O.)

Dr. Joseph Donley , MD

Emergency Medicine

NPI 1124302799

Doctor of Medicine (M.D.)

Dr. Omar Hasnie , DO

Emergency Medicine

NPI 1174767644

Doctor of Osteopathic Medicine (D.O.)

Tracy Mangan , NP

Nurse Practitioner

NPI 1225413487

Nurse Practitioner

Jessica Compton , PNP-AC

Nurse Practitioner

NPI 1336525914

PNPAC

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 02, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location September 02, 2014

Registered at 7950 W JEFFERSON BLVD, FORT WAYNE, IN 468044140 (Tel: 2602039600)

📍
Updated Business Mailing Address September 02, 2014

Registered at 10351 DAWSONS CREEK BLVD, SUITE A-1, FORT WAYNE, IN 468251904 (Tel: 2602039600)

👤
Provider Name / Credentials Updated September 02, 2014

Recorded as DERRICK WILLIAMS, RN, APRN, ACNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 02, 2014

Nurse Practitioner (License #71003104A in IN)

🟢
Initial NPI Registration & Enumeration October 06, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1922333194
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 06, 2009
Last Update: September 02, 2014
Sole Proprietor: Yes

Mailing Address

10351 Dawsons Creek Blvd, Suite A-1

Fort Wayne, IN 468251904

Phone: 2602039600

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.