Angela Lee Willis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

40253 Issued in TN

Practice address

5651 Frist Blvd
Suite 713
Hermitage, TN 37076-2054

Phone

(615) 316-5662

Fax

(615) 316-5666

NPI assigned

Oct 17, 2005

Last updated

Apr 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: angela.willis.p2@direct.alegiscare.nextgenshare.com
• Direct secure messaging: angelawillismd@awfpp-tn.direct.office.nextgen.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Angela Willis Family Practice PLLC

  • Family Medicine Physician
  • Hermitage, TN
  • NPI 1891151981
  Authorized official Same address or phone
• Columbia Medical Group-Southern Hills Inc

  • Family Medicine Physician
  • Nashville, TN
  • NPI 1700873171
  NPD (past)
• Willis Family Medical Center, P.C.

  • Family Medicine Physician
  • Hermitage, TN
  • NPI 1558616532
  NPD (past)

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1205825866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5651 FRIST BLVD",
            "address_2": "SUITE 713",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762054",
            "telephone_number": "615-316-5662",
            "fax_number": "615-316-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 FRIST BLVD",
            "address_2": "SUITE 713",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762054",
            "telephone_number": "615-316-5662",
            "fax_number": "615-316-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ANGELA",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD40253",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "40253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3335851",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kameela E Williams-Jackson, APN
• Amanda Williams, OT
• Cynthia Renee' Williams, NURSE PRACTITIONER
• Lisa Gay Williams, O.D.
• Willis Family Medical Center, P.C.
• Kayla Nicole Wilson
• Robert Terry Winfree, DDS
• Gregory D. Witters, M.D.
• Peter Wojtkiewicz, D.M.D.
• Christopher Wolfe, P.T.

• Family Medicine Physician in Hermitage, TN
• Providers in Hermitage, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.