NPIMap

Individual provider Active NPI

Alan K Willis, M.D.

  • Vascular Surgery Physician
  • Boaz, AL
National Provider Identifier
1225219256
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
26664 Issued in AL
Practice address
2505 US Highway 431
Boaz, AL 35957-5908
Phone
(256) 894-6800
Fax
(256) 894-6808
NPI assigned
Nov 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 26664 AL
Vascular Surgery Physician 2086S0129X 26664 AL Primary

Addresses

Primary practice location

2505 US Highway 431
Boaz, AL 35957-5908

Mailing address

2505 US Highway 431
Boaz, AL 35957-5908
Phone (256) 894-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101022000784 AL Practitioner - Vascular SurgeryPractitioner - General Surgery 1355534363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
University of Alabama School of Medicine, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Northeast Alabama Vascular and Vein SpecialistGroup PAC ID 3375872088, 2 clinicians

Practice addresses (Care Compare)

11491 US Hwy 431
Albertville, AL 35950-0136
Phone (256) 894-6800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as apm
Quality
82.81
Promoting interoperability
83.07
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal174
Leg revascularization (restoring blood flow)65
Removal of tissue19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center South Vascular Surgery Current Accepting new patients
Northeast Alabama Vascular and Vein Specialist Vascular Surgery CurrentSince Jul 1, 2019 Accepting new patients
Marshall Medical Center North Past Accepting new patients
Marshall Medical Center South PastSince Aug 4, 2023 Accepting new patients
HH Health System - Marshall LLC Past Accepting new patients

Locations

11491 US Highway 431
Albertville, AL 35950
Phone (256) 894-6700

133 Wall St
Albertville, AL 35951
Phone (256) 571-8477

2505 US Highway 431
Boaz, AL 35957
Phone (256) 506-0061

2505 US Highway 431
Ste B
Boaz, AL 35957
Phone (256) 840-3396

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/marshso-0747d29f
  • FHIR API: https://fhir-usa.unify.chbase.com/org/marshso-ac1b915e

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1225219256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 US HIGHWAY 431",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575908",
            "telephone_number": "256-894-6800",
            "fax_number": "256-894-6808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 US HIGHWAY 431",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359575908",
            "telephone_number": "256-894-6800",
            "fax_number": "256-894-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ALAN",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-19",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "26664",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AL",
            "license": "26664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boaz, AL

Sources for this page

Verify at the official NPI Registry.