Travis R Willey, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

9980 Issued in CO

Practice address

4745 Boardwalk Dr Ste D102
Fort Collins, CO 80525-3773

Phone

(970) 223-6101

Fax

(970) 530-1593

NPI assigned

Jul 22, 2009

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

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Travis Willey, DDS PC

  • Dentist
  • Fort Collins, CO
  • NPI 1043717382
  NPD (past)

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043440282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 BOARDWALK DR STE D102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253773",
            "telephone_number": "970-223-6101",
            "fax_number": "970-530-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 BOARDWALK DR STE D102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253773",
            "telephone_number": "970-223-6101",
            "fax_number": "970-530-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEY",
        "first_name": "TRAVIS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "9980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Will
• Toni Renae Will
• Rachel Nicole Willard, DPT
• Alex Willen, LMT, BCSI
• Elizabeth Morgan Willes
• William J Thieman MD PC
• Lisa N William, BSW
• Kathy Williams-Tolstrup, M.ED.
• Amanda Williams, RDH, OMT
• Blakely Sjostedt Williams, LCSW

• Dentist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.