Adam M Willis, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

027046-1 Issued in NY

Practice address

206 Glen St
Suite #52
Glens Falls, NY 12801-3584

Phone

(518) 538-8778

Fax

(518) 636-3204

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Adirondack Manual Physical Therapy, PLLC

  • Physical Therapist
  • Queensbury, NY
  • NPI 1760772701
  Medicare reassignment NPD Authorized official
• Hudson Falls Physical Therapy PT PC

  • Physical Therapist
  • Hudson Falls, NY
  • NPI 1871656876
  NPD (past)
• Loudoun Physical Therapy, Inc.

  • Physical Therapist
  • Leesburg, VA
  • NPI 1629128152
  NPD (past)
• Virginia Hospital Center Arlington Health System

  • Pharmacy
  • Arlington, VA
  • NPI 1790045052
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1073614285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 MAIN ST",
            "city": "SOUTH GLENS FALLS",
            "state": "NY",
            "postal_code": "128035118",
            "telephone_number": "518-225-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 GLEN ST",
            "address_2": "SUITE #52",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013584",
            "telephone_number": "518-538-8778",
            "fax_number": "518-636-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ADAM",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204833",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010625",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027046-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF L&I",
            "identifier": "0223203",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE/BLUE SHIELD",
            "identifier": "6393WI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIMS",
            "identifier": "8944992",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "92527059",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE/BLUE SHIELD",
            "identifier": "2639WI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE/BLUESHIELD",
            "identifier": "2149WI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "2305204833",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Wilder X, R. PH
• Kerri A Wilkes, OT
• William C. Brender MD, PC
• Sheri Ann Williams
• Kristin L Williford, PA
• Michelle Winchell, LPN
• Kathryn Wisniewski, PHARMD
• Womens Care in Obstetrics and Gynecology PC
• Carlie Wood, PA
• Carrie Wood

• Physical Therapist in Glens Falls, NY
• Providers in Glens Falls, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.