Active NPI
Joseph Gene Willis, PT
- Physical Therapist
- Viroqua, WI
National Provider Identifier
1023347531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10245-024
- Practice address
- 507 S Main St
Viroqua, WI 54665-2059 - Phone
- (608) 637-4385
- Fax
- (608) 637-4382
- NPI assigned
- Dec 11, 2009
- Last updated
- Dec 11, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10245-024 | WI | Primary |
Addresses
Primary practice location
507 S Main St
Viroqua, WI 54665-2059
Mailing address
507 S Main St
Viroqua, WI 54665-2059
Phone (608) 637-4385
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10245-024 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurosport Physical Therapy & Rehabilitation Specialist Inc. | Physical Therapist | Past | Accepting new patients |
| Kennestone Hospital, Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- NPI 1689361438
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- Physical Therapist
- Marietta, GA
- NPI 1376546341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260489600000",
"number": "1023347531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 S MAIN ST",
"city": "VIROQUA",
"state": "WI",
"postal_code": "546652059",
"telephone_number": "608-637-4385",
"fax_number": "608-637-4382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 S MAIN ST",
"city": "VIROQUA",
"state": "WI",
"postal_code": "546652059",
"telephone_number": "608-637-4385",
"fax_number": "608-637-4382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "JOSEPH",
"middle_name": "GENE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-12-11",
"last_updated": "2009-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "10245-024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Viroqua, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.