Individual provider Active NPI

Stephanie Willis, D.O.

  • Internal Medicine Physician
  • Temple Terrace, FL
National Provider Identifier
1093198368
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS15134 Issued in FL
Practice address
13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone
(813) 779-6303
Fax
(888) 977-1998
NPI assigned
Jul 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X OS15134 FL
Internal Medicine Physician 207R00000X OS15134 FL Primary

Addresses

Primary practice location

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926

Mailing address

13067 N Telecom Pkwy
Temple Terrace, FL 33637-0926
Phone (813) 779-6303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180920001086 FL Practitioner - Internal MedicinePractitioner - Hospitalist 4082965660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (813) 615-7075

Hospital & facility affiliations

  • Adventhealth Home Health Home health agency, Temple Terrace, FL, CCN 107414
  • AdventHealth Carrollwood Hospital, Tampa, FL, CCN 100069
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS15134FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Physician Group Inc Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients
Pioneer Medical Group, PL Internal Medicine CurrentSince Dec 6, 2018 Accepting new patients
Adventist Health System-Sunbelt Inc Internal Medicine Past Accepting new patients

Locations

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

13067 N Telecom Pkwy
Temple Terrace, FL 33637
Phone (813) 333-9108

12470 Telecom Dr
Ste 100
Temple Terrace, FL 33637
Phone (813) 929-5454

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

38250 A Ave
Zephyrhills, FL 33542
Phone (813) 732-5608

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1093198368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13067 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370926",
            "telephone_number": "813-779-6303",
            "fax_number": "888-977-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13067 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370926",
            "telephone_number": "813-779-6303",
            "fax_number": "888-977-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-06",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS15134",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS15134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

Verify at the official NPI Registry.