Individual provider Active NPI

Wendy J Willey, RN, MS, ACNP

  • Acute Care Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1174709455
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
COA.09939-NP Issued in OH
Practice address
7700 Washington Village Dr
Suite 230
Dayton, OH 45459-3953
Phone
(937) 438-0099
Fax
(937) 438-0902
NPI assigned
Jan 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X COA.09939-NP OH Primary

Addresses

Primary practice location

7700 Washington Village Dr
Suite 230
Dayton, OH 45459-3953

Mailing address

7700 Washington Village Dr
Suite 220
Dayton, OH 45459-3953
Phone (937) 438-0099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
COA.09939-NPOHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Physicians Inc Past Accepting new patients

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": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1174709455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 WASHINGTON VILLAGE DR",
            "address_2": "SUITE 220",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593953",
            "telephone_number": "937-438-0099",
            "fax_number": "937-438-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 WASHINGTON VILLAGE DR",
            "address_2": "SUITE 230",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593953",
            "telephone_number": "937-438-0099",
            "fax_number": "937-438-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEY",
        "first_name": "WENDY",
        "middle_name": "J",
        "credential": "RN, MS, ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-16",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "COA.09939-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.