Active NPI
Eric Lee Willey, PTA
- Physical Therapy Assistant
- Milford, DE
National Provider Identifier
1215714928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- CP025142A
- Practice address
- 500 S Dupont Blvd
Milford, DE 19963-1758 - Phone
- (302) 422-8700
- NPI assigned
- Sep 14, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | CP025142A | DE | Primary |
Addresses
Primary practice location
500 S Dupont Blvd
Milford, DE 19963-1758
Mailing address
169 Silas Ridge LN
Ararat, NC 27007-8466
Phone (743) 444-2705
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP025142A | DE | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694649600000",
"number": "1215714928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 SILAS RIDGE LN",
"city": "ARARAT",
"state": "NC",
"postal_code": "270078466",
"telephone_number": "743-444-2705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S DUPONT BLVD",
"city": "MILFORD",
"state": "DE",
"postal_code": "199631758",
"telephone_number": "302-422-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLEY",
"first_name": "ERIC",
"middle_name": "LEE",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-14",
"last_updated": "2023-09-14",
"certification_date": "2023-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "DE",
"license": "CP025142A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.