Tamila Willis, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

270116 Issued in AZ

Practice address

1300 S 20TH Ave
Safford, AZ 85546-3301

Phone

(928) 428-3122

Fax

(928) 428-7917

NPI assigned

Jan 4, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Prescott Healthcare Solutions LLC

  • Family Medicine Physician
  • Prescott, AZ
  • NPI 1821454505
  Medicare reassignment NPD

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1225799018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855463301",
            "telephone_number": "928-428-3122",
            "fax_number": "928-428-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855463301",
            "telephone_number": "928-428-3122",
            "fax_number": "928-428-7917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "TAMILA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN153089",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "270116",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "270116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason W White, CRNA
• Cyndle Whitmer
• Jared M Wilhelm, LPC, MC
• Williams Dentistry PLLC
• Stacy Rene Williams, D.M.D.
• Jessica Lynn Wilson, NP
• Sarah Dawn Wilson, P. A. C.
• Loni Kay Woodall-Sanders, M.S., CCC-SLP
• Kyla Woodward, RDH
• Joel G Wright, M.D.

• Family Nurse Practitioner in Safford, AZ
• Providers in Safford, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.