Active NPI
Annie Elizabeth Willsey
- Physical Therapist
- Lehigh Acres, FL
National Provider Identifier
1275303836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT41175
- Practice address
- 4316 Lee Blvd Unit 12B
Lehigh Acres, FL 33971-1735 - Phone
- (239) 368-7744
- NPI assigned
- Jan 4, 2024
- Last updated
- Jan 22, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | ||
| Physical Therapist | 225100000X | 30170 | MD | |
| Physical Therapist | 225100000X | 050549-01 | NY | |
| Physical Therapist | 225100000X | PT41175 | FL | Primary |
Addresses
Primary practice location
4316 Lee Blvd Unit 12B
Lehigh Acres, FL 33971-1735
Mailing address
4316 Lee Blvd Unit 12B
Lehigh Acres, FL 33971-1735
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30170 | MD | MD | Social Worker |
| PT41175 | FL | MD | Physical Therapist |
| 050549-01 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Washington Healthcare Physicians | Physical Therapist | Current | Accepting new patients |
| Mary Washington Healthcare Physicians | Current | Accepting new patients |
Locations
1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100
9530 Cosner Dr
Ste 101
Fredericksburg, VA 22408
Networks
- Freedom Health HMO Network
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Fredericksburg, VA
- NPI 1295999852
Physical Therapist
-
- Durable Medical Equipment & Medical Supplies
- Fredericksburg, VA
- NPI 1740853035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737504000000",
"number": "1275303836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4316 LEE BLVD UNIT 12B",
"city": "LEHIGH ACRES",
"state": "FL",
"postal_code": "339711735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4316 LEE BLVD UNIT 12B",
"city": "LEHIGH ACRES",
"state": "FL",
"postal_code": "339711735",
"telephone_number": "239-368-7744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLSEY",
"first_name": "ANNIE",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-04",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "30170",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "050549-01",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT41175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lehigh Acres, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.