Boice Willis Clinic PA

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

38821 Issued in NC

Legal business name

BOICE WILLIS CLINIC PA

Doing business as

Boice-Willis Clinic Endoscopy Center

Practice address

901 N Winstead Ave Ste 310
Rocky Mount, NC 27804-8467

Phone

(252) 937-0291

Fax

(252) 451-0056

NPI assigned

Oct 6, 2006

Last updated

Aug 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin Adams

Title

Revenue Cycle Supervisor

Phone

(252) 937-0486

Specialties & licenses 1

Addresses

Other names 1

• Boice-Willis Clinic Endoscopy Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Boice-Willis Clinic PA

  • Internal Medicine Physician
  • Rocky Mount, NC
  • NPI 1699722389

  0143122382

  Same PAC ID
• Boice-Willis Clinic, PA

  • Clinical Medical Laboratory
  • Rocky Mount, NC
  • NPI 1598911885

  0143122382

  Same PAC ID

Listed as

Boice Willis ClinicCCN 34C0001147

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Boice Willis Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Boice-Willis Clinic, PA

  • Physical Therapy Clinic/Center
  • Rocky Mount, NC
  • NPI 1952557241
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HGIHAA

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1144317470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7200",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040200",
            "telephone_number": "252-937-0200",
            "fax_number": "252-451-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N WINSTEAD AVE STE 310",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048467",
            "telephone_number": "252-937-0291",
            "fax_number": "252-451-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOICE WILLIS CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "REVENUE CYCLE SUPERVISOR",
        "authorized_official_telephone_number": "252-937-0486"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NC",
            "license": "38821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boice-Willis Clinic Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boice-Willis Clinic Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bloem Orthopaedic Center, P.a.
• Josephus TH Bloem, MD
• Kristin McGinnis Blonk, DNP, CRNA
• BN Healthcare, LLC (South Village)
• Crystal L Bobbitt, LMFTA
• Boice-Willis Clinic PA
• Boice-Willis Clinic, PA
• Boice-Willis Clinic, PA
• India Monaye Bolden
• Chineta Bond II

• Endoscopy Clinic/Center in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Endoscopy Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.