Annette Pearl Ville, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

T1877 Issued in TX

Practice address

971 11TH Ave
Longview, WA 98632-2503

Phone

(360) 423-6140

NPI assigned

Mar 29, 2019

Sex

Female

Sole proprietor

No

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

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aville91177@direct.phhs.org

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.

• Dallas Physician Medical Services for Children Inc

  dba Children's Health Medical Group

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1194153650
  Medicare reassignment NPD
• Dallas Physician Medical Services for Children Inc

  dba Children's Health Medical Group

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1558407908
  NPD
• Child & Adolescent Clinic, PS

  • Pediatrics Physician
  • Longview, WA
  • NPI 1144275777
  NPD (past)

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1093276123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322503",
            "telephone_number": "360-423-6140",
            "fax_number": "360-423-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322503",
            "telephone_number": "360-423-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLE",
        "first_name": "ANNETTE",
        "middle_name": "PEARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T1877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irma Vicentainer, BA, R-AAC
• Victory Healthcare LLC (Victory Diabetes and Primary Clinic)
• Lizbeth Guadalupe Vigil
• Carrie Jean Vigoren, LMT
• Carol Villalobos
• David A Vogel, OT
• Victoria Vogle, DO
• Juniper W Vojta, PMHNP
• Taylor Voth, AAC
• W. Kalob Lesh DDS PLLC

• Pediatrics Physician in Longview, WA
• Providers in Longview, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.