Individual provider Active NPI

Hannah Davis Wills

  • Advanced Practice Midwife
  • Valdosta, GA
National Provider Identifier
1174205694
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN277815 Issued in GA
Practice address
220 Northside Dr
Valdosta, GA 31602-1858
Phone
(229) 241-2800
NPI assigned
Aug 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN277815 GA
Advanced Practice Midwife 367A00000X RN277815 GA Primary

Addresses

Primary practice location

220 Northside Dr
Valdosta, GA 31602-1858

Mailing address

235 Parks Memorial Building
Campus Box 63
Milledgeville, GA 31061
Phone (478) 445-1076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241010001857 GA Practitioner - Certified Nurse Midwife (CNM) 9830621283 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern OB GYN Associates P C CurrentSince Jul 29, 2024 Accepting new patients

Locations

220 Northside Dr
Valdosta, GA 31602
Phone (229) 241-2800

Interoperability endpoints

  • Direct secure messaging: hannahwills@sobgyn.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1174205694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 PARKS MEMORIAL BUILDING",
            "address_2": "CAMPUS BOX 63",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "31061",
            "telephone_number": "478-445-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 NORTHSIDE DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021858",
            "telephone_number": "229-241-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "HANNAH",
        "middle_name": "DAVIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN277815",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN277815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.