Mary E Willy, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DR0045400 Issued in CO

Practice address

360 W Park Dr
Suite 201
Grand Junction, CO 81505

Phone

(970) 609-7337

Fax

(970) 233-9829

NPI assigned

Feb 1, 2006

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

• Mary E McCrum Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwilly@altp.pcc-direct.com

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.

• Altitude Pediatrics

  • Pediatrics Physician
  • Grand Junction, CO
  • NPI 1588235345
  NPD
• Altitude Pediatrics

  • Pediatrics Physician
  • Grand Junction, CO
  • NPI 1720740095
  NPD
• St. Mary'S Hospital and Medical Center, Inc.

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1699716027
  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1073584462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W PARK DR",
            "address_2": "SUITE 201",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81505",
            "telephone_number": "970-609-7337",
            "fax_number": "970-233-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W PARK DR",
            "address_2": "SUITE 201",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81505",
            "telephone_number": "970-609-7337",
            "fax_number": "970-233-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLY",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0045400",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR0045400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MCCRUM",
            "middle_name": "E",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie W Williams, MFTC
• Zenova Williams
• Jonathan Justan Williamson
• Michele Willis, M.D.
• Carl Willoughby, LPC
• Andrea Lyn Wilson, M.A., CACII
• Angela Marie Wilson
• Claire Renee Wilson
• Elena Rae Wilson
• Hannah Wilson

• Pediatrics Physician in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.