Kristin L. Willis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10003196A Issued in IN

Practice address

2451 Intelliplex Dr
Ste 260
Shelbyville, IN 46176-8580

Phone

(317) 398-0121

Fax

(317) 398-0538

NPI assigned

Apr 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristin L. Wood Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Major HospitalGroup PAC ID 0446167415, 100 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suburban Home Health LLC Home health agency, Noblesville, IN, CCN 157092
• Major Hospital Hospital, Shelbyville, IN, CCN 150097

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: majorhospital@direct.majorhospital.org
• Direct secure messaging: kristinwillis@sfc.allscriptsdirect.net

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  Medicare reassignment Care Compare group NPD
• Major Multispecialty Associates

  • Internal Medicine Physician
  • Shelbyville, IN
  • NPI 1437398492
  Medicare reassignment NPD
• Indiana University Health Care Associates, Inc

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1902032832
  Medicare reassignment
• Indiana University Health Care Associates, Inc.

  • Registered Dietitian
  • Indianapolis, IN
  • NPI 1679949002
  NPD
• Major Hospital

  • Rural Health Clinic/Center
  • Shelbyville, IN
  • NPI 1689421554
  NPD
• Major Multispecialty Associates

  • Orthopaedic Surgery Physician
  • Shelbyville, IN
  • NPI 1245405869
  NPD
• X-Ray Physicians of Shelbyville PC

  • Diagnostic Radiology Physician
  • Shelbyville, IN
  • NPI 1144351347
  NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD
• Major Hospital

  • Skilled Nursing Facility
  • Gary, IN
  • NPI 1306953740
  NPD (past)
• Memorial Expresscare, LLC

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1750532362
  NPD (past)
• Prairie Cardiovascular Consultants LTD

  • Cardiovascular Disease Physician
  • Springfield, IL
  • NPI 1659539559
  NPD (past)

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

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  Care Compare affiliation
• Suburban Home Health, LLC

  • Home Health Agency
  • Noblesville, IN
  • NPI 1598872939
  Care Compare affiliation

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1063534253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W RAMPART ST",
            "address_2": "STE 200",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768846",
            "telephone_number": "317-421-2012",
            "fax_number": "317-398-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 INTELLIPLEX DR",
            "address_2": "STE 260",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768580",
            "telephone_number": "317-398-0121",
            "fax_number": "317-398-0538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627023719",
            "country_code": "US",
            "telephone_number": "217-528-7541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7140 E Washington St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462196719",
            "country_code": "US",
            "telephone_number": "317-832-1780",
            "fax_number": "317-832-1781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 W Rampart St Ste 250",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "IN",
            "postal_code": "461768897",
            "country_code": "US",
            "telephone_number": "317-398-7644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KRISTIN",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-002954",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003196A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristinwillis@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "800 N 1st St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627023719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "majorhospital@direct.majorhospital.org",
            "affiliation": "Y",
            "affiliationName": "Major Hospital",
            "address_1": "2451 Intelliplex Dr",
            "address_2": "Ste 260",
            "city": "Shelbyville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461768580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "WOOD",
            "middle_name": "L.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael A Whitfield, RPH
• David Gill Whittaker, MD
• Kari Christine Willett, PT
• Kristin Willfond, MD - MPH
• Destiny Williams
• Lindsay Elizabeth Wilmer
• Colleen Wilson, RBT
• Richard Max Wilson, P.T.
• Kyle Witkemper, ATC.,LAT
• Brittany Mischelle Wood

• Physician Assistant in Shelbyville, IN
• Providers in Shelbyville, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.