Individual provider Active NPI

Hunter Willis, DO

  • Family Medicine Physician
  • Jackson, TN
National Provider Identifier
1043070899
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6431 Issued in TN
Practice address
294 Summar Dr
Jackson, TN 38301-3915
Phone
(731) 423-1932
Fax
(731) 660-8739
NPI assigned
Mar 20, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6431 TN Primary

Addresses

Primary practice location

294 Summar Dr
Jackson, TN 38301-3915

Mailing address

294 Summar Dr
Jackson, TN 38301-3915
Phone (731) 423-1932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250829002265 TN Practitioner - Family PracticePractitioner - Emergency Medicine 2264874338 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Lincoln Memorial University Medical Department, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medical Care Facilities PCGroup PAC ID 6103837877, 57 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

  • West Tennessee Healthcare Milan Hospital Hospital, Milan, TN, CCN 440060
  • Ascension Saint Thomas Three Rivers Hospital, Waverly, TN, CCN 441303
  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
  • West Tennessee Healthcare Camden Hospital Hospital, Camden, TN, CCN 441316
  • West Tennessee Healthcare Bolivar Hospital Hospital, Bolivar, TN, CCN 441320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
6431TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Care Facilities PC CurrentSince Dec 1, 2025 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Jul 23, 2025 Accepting new patients
Hospital Medicine Services of Tennessee PC Family Medicine CurrentSince Nov 1, 2025 Accepting new patients
Concord Medical Group PLLC CurrentSince Jul 23, 2025 Accepting new patients
Concord Medical Group of Kentucky PLLC CurrentSince Jul 25, 2025 Accepting new patients

Locations

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

175 Hospital Dr
Camden, TN 38320
Phone (731) 584-6135

135 E Swan St
Centerville, TN 37033
Phone (931) 729-3513

9400 Rhea County Hwy
Dayton, TN 37321
Phone (423) 285-5220

5001 E Main St
Erin, TN 37061
Phone (336) 944-6420

631 Rb Wilson Dr
Huntingdon, TN 38344
Phone (731) 986-2933

367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

4039 Highland St
Ste 1
Milan, TN 38358
Phone (731) 723-3668

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

451 Highway 13 S
Waverly, TN 37185
Phone (931) 296-0211

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1043070899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-660-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "HUNTER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-20",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "6431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.