Bruce Ranne Wills, M.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5799 Issued in FL

Practice address

650 S Courtenay Pkwy Ste 200
Merritt Island, FL 32952-4977

Phone

(321) 394-2660

Fax

(321) 394-2669

NPI assigned

May 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Privia Medical Group Florida, LLC

  • General Practice Physician
  • Indialantic, FL
  • NPI 1700649043
  NPD

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1023229853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 WHISPEROAK DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329018135",
            "telephone_number": "321-676-2055",
            "fax_number": "321-676-9928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S COURTENAY PKWY STE 200",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524977",
            "telephone_number": "321-394-2660",
            "fax_number": "321-394-2669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6050 Babcock St SE Ste 5",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329094203",
            "country_code": "US",
            "telephone_number": "321-676-2055",
            "fax_number": "321-676-9928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLS",
        "first_name": "BRUCE",
        "middle_name": "RANNE",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "PT 5799",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT5799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia Lauren Williams, MS
• Nicole Williams, BCBA
• Travia D Williams, RN
• Ana Maria Williamsen, L.M.T.
• Stephanie M Williamson, LPN
• James Henry Wilson III, MD
• Pamela Lawson Wise
• Daniel Woodard, M.D.
• Veronica Jean Wright
• Wuesthoff Brevard Cardiology Group (Brevard Cardiology Group)

• Physical Therapist in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.