Pamela K Willis, LCSW MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LCSW4499 Issued in TN

Practice address

26 Midway
Bristol, TN 37620

Phone

(423) 989-4500

Fax

(423) 989-4582

NPI assigned

Aug 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265445290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9054",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376159054",
            "telephone_number": "423-467-3600",
            "fax_number": "423-467-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 MIDWAY",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "37620",
            "telephone_number": "423-989-4500",
            "fax_number": "423-989-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "PAMELA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LCSW MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "LCSW4499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN SUMMIT",
            "identifier": "4125310",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "334969",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN NAVIGATOR",
            "identifier": "4125310",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PINNACLE",
            "identifier": "4125310",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John F Williams, MD
• Kendrick Williams, MD
• Marcus G Williams, MD
• Ronald L Williams, MD
• Travis David Williams, N.P.
• Amy L Willocks
• Wilson Pharmacy, Inc.
• Anna Lee Wilson
• Donovan Dean Wilson
• Earl Keith Wilson, MD

• Social Worker in Bristol, TN
• Providers in Bristol, TN by specialty
• Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.