Mary Lauren Elizabeth Willis, PHARMD, BCOP

Primary specialty

Oncology PharmacistTaxonomy code 1835X0200X

License

015909 Issued in KY

Practice address

4251 Mooncoin Way
Lexington, KY 40515

Phone

(859) 806-8420

NPI assigned

Oct 10, 2016

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1043760465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 MOONCOIN WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156045",
            "telephone_number": "859-806-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 MOONCOIN WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40515",
            "telephone_number": "859-806-8420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 Rose St",
            "address_2": "Combs Cancer Research Center Room 304",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360096",
            "country_code": "US",
            "telephone_number": "859-218-6190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MARY LAUREN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHARMD, BCOP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835X0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Oncology",
            "state": "KY",
            "license": "015909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Clay Willis
• Eric Willis, PHARM.D.
• Erica Willis
• Holly Willis, APRN
• Lauren Willis
• Shirley Ann Willis, CTRS, ADC
• Jason Alexander Willoughby, MHS, OTR/L, CHT
• Laura Denise Willoughby, OT
• Willow Creek Counseling Center LLC
• Willow Tree Pediatrics of Lexington

• Oncology Pharmacist in Lexington, KY
• Providers in Lexington, KY by specialty
• Oncology Pharmacist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; 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.