Active NPI
Laura Bryce Willis, MCD
- Speech-Language Pathologist
- Auburn, AL
National Provider Identifier
1023213410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2703
- Practice address
- 1199 Haley Ctr
Auburn, AL 36849-5232 - Phone
- (334) 844-9600
- Fax
- (334) 844-9684
- NPI assigned
- Jun 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2703 | AL | Primary |
Addresses
Primary practice location
1199 Haley Ctr
Auburn, AL 36849-5232
Mailing address
1199 Haley Ctr
Auburn, AL 36849-5232
Phone (334) 844-9600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161205000679 | AL | Practitioner - Qualified Speech Language Pathologist | 0941580104 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1199 Haley Ctr
Auburn University, AL 36849-0001
Phone (334) 844-9600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Auburn University | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Health Service Clinic/Center
- Montgomery, AL
- NPI 1376836163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684713600000",
"number": "1023213410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1199 HALEY CTR",
"city": "AUBURN",
"state": "AL",
"postal_code": "368495232",
"telephone_number": "334-844-9600",
"fax_number": "334-844-9684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1199 HALEY CTR",
"city": "AUBURN",
"state": "AL",
"postal_code": "368495232",
"telephone_number": "334-844-9600",
"fax_number": "334-844-9684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "LAURA",
"middle_name": "BRYCE",
"credential": "MCD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-18",
"last_updated": "2023-05-22",
"certification_date": "2023-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "2703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.