Bronwyn K Willis, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

029 Issued in NM

Practice address

1201 Atrisco Dr SW
Atrisco Es
Albuquerque, NM 87105-3550

Phone

(505) 877-2772

NPI assigned

Feb 2, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1265764229",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "1201 ATRISCO DR SW",
            "address_2": "ATRISCO ES",
            "city": "ALBUQUERQUE",
            "state": "NEW MEXICO",
            "postal_code": "87105",
            "telephone_number": "505-877-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 ATRISCO DR SW",
            "address_2": "ATRISCO ES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053550",
            "telephone_number": "505-877-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "BRONWYN",
        "middle_name": "K",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NONE ASSIGNED",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Michelle Willie, RN
• Taylor Williford
• Lori Willinghurst, M.D.
• Anna I Willis
• Austin Glenn Willis, DO
• Darrell Willis, RPH
• Deborah Lawan Willis, M.S., CCC-SLP
• Gillian Willis
• Joshua A Willis
• Linda Carol Willis, MSW, LMSW

• Occupational Therapist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Occupational Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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.