Clifton Augustus Willoughby, PTA/ATC

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA010757 Issued in OH

Practice address

6210 Cleves Warsaw Pike
Cincinnati, OH 45233-4510

Phone

(513) 309-2825

NPI assigned

Jan 24, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1003370966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 CLEVES WARSAW PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452334512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6210 CLEVES WARSAW PIKE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452334510",
            "telephone_number": "513-309-2825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "CLIFTON",
        "middle_name": "AUGUSTUS",
        "credential": "PTA/ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA010757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vonda K Willis, LPCC
• Zachary Willis, M.D.
• McKenzie Graham Willits
• Kevin James Willmarth, PSY.D.
• Charity Willoughby, CNP
• Joshua Nathan Willoughby, PHARMD
• Rita Michelle Willoughby
• Rebekah Wills
• Stacey Ann Wills, RN
• Lisa Willshaw, PHARMD

• Physical Therapy Assistant in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.