Arnold J Willis, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

LT4196 Issued in NH

Practice address

590 Court St
Keene, NH 03431-1719

Phone

(603) 354-5400

NPI assigned

Aug 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Enrolled in WA, WY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Memorial Hospital of Sweetwater County

  • Critical Access Hospital
  • Rock Springs, WY
  • NPI 1558361949
  Medicare reassignment NPD
• Sunnyside Community Hospital Association

  • Rural Health Clinic/Center
  • Sunnyside, WA
  • NPI 1679521637
  Medicare reassignment
• Memorial Hospital of Sweetwater County

  • Internal Medicine Physician
  • Rock Springs, WY
  • NPI 1437312436
  NPD
• Sunnyside Community Hospital Association

  • Rural Health Clinic/Center
  • Sunnyside, WA
  • NPI 1407289184
  NPD
• Sunnyside Community Hospital Association

  • Clinic/Center
  • Yakima, WA
  • NPI 1609395060
  NPD
• Sunnyside Community Hospital Association

  • Urgent Care Clinic/Center
  • Yakima, WA
  • NPI 1720507122
  NPD
• Doctors Community Hospital

  • Endocrinology, Diabetes & Metabolism Physician
  • Lanham, MD
  • NPI 1548201536
  NPD (past)
• Luminis Health Doctors Community Medical Center, Inc.

  • General Acute Care Hospital
  • Lanham, MD
  • NPI 1730136532
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1275525545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311719",
            "telephone_number": "603-354-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311719",
            "telephone_number": "603-354-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1707 Meadows Ln Ste F",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304747201",
            "country_code": "US",
            "telephone_number": "912-537-9481",
            "fax_number": "912-537-1380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ARNOLD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "85836",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WY",
            "license": "TL6077",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "DC",
            "license": "MD9513",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MD",
            "license": "D0020464",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NH",
            "license": "LT4196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1095850",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN HOPKINS",
            "identifier": "028055",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE AMERICHOICE",
            "identifier": "1901104",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00439848",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023376900",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY PARTNERS",
            "identifier": "028055",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1467393",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "35301905",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DC",
            "identifier": "57620005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4053748",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "35301902",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM CHOICE",
            "identifier": "45428",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO HEALTH",
            "identifier": "432105237",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin M Wilkie
• Hudson John Willett, BA
• Brian C Willette
• Adrienne Jean Williams, APRN
• Gail Eileen Williams, MS
• Sarah Hart Wills, LICSW
• Donald V. Wilson, MD
• Douglass Charles Wilson, D.M.D
• Heidi Ann Wilson
• Jewel P Wilson

• Urology Physician in Keene, NH
• Providers in Keene, NH by specialty
• Urology Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; 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.