NPIMap

Organization Active NPI

Wayne S. Willis MD LLC

  • Primary Care Clinic/Center
  • Pensacola, FL
National Provider Identifier
1215349535
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
25944 Issued in FL
Legal business name
WAYNE S. WILLIS MD LLC
Practice address
3111 Peggy Bond Dr
Pensacola, FL 32504-5018
Phone
(850) 438-9755
Fax
(850) 438-0699
NPI assigned
May 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Authorized official

Name
Kayla Hughes
Title
Office Manager
Phone
(850) 438-9755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 25944 FL Primary

Addresses

Primary practice location

3111 Peggy Bond Dr
Pensacola, FL 32504-5018

Mailing address

3111 Peggy Bond Dr
Pensacola, FL 32504-5018
Phone (850) 438-9755

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1215349535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 PEGGY BOND DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045018",
            "telephone_number": "850-438-9755",
            "fax_number": "850-438-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 PEGGY BOND DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045018",
            "telephone_number": "850-438-9755",
            "fax_number": "850-438-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE S. WILLIS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-21",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-438-9755"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "25944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.