Ashley Stanczak Willis, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN241647 Issued in GA

Practice address

1226 Dantignac St
Augusta, GA 30901-2788

Phone

(706) 922-0600

NPI assigned

Jan 27, 2019

Last updated

Jan 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christ Community Health Services Augusta, Inc.

  • Primary Care Clinic/Center
  • Augusta, GA
  • NPI 1174716989
  Medicare reassignment
• Christ Community Health Services Augusta, Inc

  • Federally Qualified Health Center (FQHC)
  • Augusta, GA
  • NPI 1992448476
  NPD
• Christ Community Health Services Augusta, Inc

  • Federally Qualified Health Center (FQHC)
  • Augusta, GA
  • NPI 1043568264
  NPD (past)
• Christ Community Health Services Augusta, Inc

  • Federally Qualified Health Center (FQHC)
  • Augusta, GA
  • NPI 1073192985
  NPD (past)

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

{
    "created_epoch": "1548547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1255895975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 DANTIGNAC ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012788",
            "telephone_number": "404-520-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 DANTIGNAC ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012788",
            "telephone_number": "706-922-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ASHLEY",
        "middle_name": "STANCZAK",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-27",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN241647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon Stokely Williford, M.D.
• Keisha Ann Williford, OD
• Rebecca Williford
• Eleanor Willingham
• Alexandra Clark Willis
• Connie Rae Willis, R.D.
• Lauren Willis, PHD, PHARMD
• Samuel Andersen Willis, M.D.
• Stacy L Willis, BS
• Edward Terrell Wills, D.O.

• Pediatric Nurse Practitioner in Augusta, GA
• Providers in Augusta, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.