Michael B Willis, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1501 Kings Hwy
Shreveport, LA 71103-4228

Phone

(318) 675-5000

NPI assigned

Aug 1, 2013

Sex

Male

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 LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Louisiana State University Health Sciences Center

  dba LSU Health Shreveport

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1417992249
  Medicare reassignment NPD
• Northern Louisiana Emergency Physicians, LLP

  dba Northern Louisiana Physicians LLP

  • Emergency Medicine Physician
  • Ruston, LA
  • NPI 1588828172

  Physician Assistant

  Medicare reassignment NPD
• University Health Shreveport LLC

  dba Ochsner LSU Health Shreveport

  • Nurse Practitioner
  • Shreveport, LA
  • NPI 1619443611

  Physician Assistant

  Medicare reassignment NPD
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222
  Medicare reassignment
• Louisiana State University Health Sciences Center Shreveport

  dba Louisiana State University Health Sciences Center Shreveport Guide

  • Multi-Specialty Clinic/Center
  • Shreveport, LA
  • NPI 1790720738
  NPD

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1164854154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W KIRBY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033822",
            "telephone_number": "318-675-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-675-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kavori Rishe Willis, BS- PSYCHOLOGY
• Kenya Washington Willis, RPH
• Lakisha Willis
• Lindsey Willis, LPC
• Melanie Yvette Willis, FNP-C
• Nekeicha Willis
• Reginald Willis
• Shalena Willis
• Tyekia Willis
• Willow Point Baptist Healing Heart Counseling Center

• Physician Assistant in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.