Tina Marie Wills, OPTOMETRY TECH

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

126 Missouri Ave. Eent Clinic
Jeneral Leonard Wood Army Community Hospital
Fort Leonard Wood, MO 65473

Phone

(573) 596-0131

Fax

(573) 596-0086

NPI assigned

Sep 9, 2010

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1144537366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE. EENT CLINIC",
            "address_2": "JENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "65473",
            "telephone_number": "573-596-0131",
            "fax_number": "573-596-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE. EENT CLINIC",
            "address_2": "JENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "65473",
            "telephone_number": "573-596-0131",
            "fax_number": "573-596-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OPTOMETRY TECH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelly Mae Wiley
• Aireal Williams, RD
• Christopher Williams, P.T.
• Crysta Williams, PA-C
• Solomon John Williams, LMSW, LCDC
• James Wilson
• Susan Diane Wilson, F.N.P.
• Susan Marie Wolf
• Lillian Wolfe, LPN
• John Sebastian Wong, CRNA

• Other Technician in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Other Technician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.