Individual provider Active NPI

John Evan Willis, CRNP

  • Nurse Practitioner
  • Madison, AL
National Provider Identifier
1275831703
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-114309 Issued in AL
Practice address
300 Sun Temple Dr
Madison, AL 35758-5919
Phone
(256) 325-9111
Fax
(256) 325-9113
NPI assigned
Mar 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-114309 AL Primary

Addresses

Primary practice location

300 Sun Temple Dr
Madison, AL 35758-5919

Mailing address

300 Sun Temple Dr
Madison, AL 35758-5919
Phone (256) 325-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20110404000709 AL Practitioner - Nurse Practitioner 2961686654 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Family Care IncGroup PAC ID 7618103748, 56 clinicians

Practice addresses (Care Compare)

1115 Beltline Rd SE
Suite 400
Decatur, AL 35601-6556
Phone (256) 898-3004

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-114309ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Clinic LLC CurrentSince Dec 22, 2013 Accepting new patients
Sleep & Pulmonary Care Center, P.C. CurrentSince Feb 28, 2014 Accepting new patients
Southview Medical Clinic LLC CurrentSince Dec 22, 2013 Accepting new patients
Advantage Family Care Inc CurrentSince Sep 24, 2025 Accepting new patients
Midway Medical Clinic LLC CurrentSince Dec 22, 2013 Accepting new patients
Advantage Family Care, Inc. CurrentSince Sep 24, 2025 Accepting new patients
Crestwood Physician Services, LLC CurrentSince Feb 26, 2014 Accepting new patients
Horizon Medical Clinic LLC CurrentSince Dec 22, 2013 Accepting new patients
Valley Pain Clinic LLC Past Accepting new patients
Growing Up Pediatrics, P.C. Past Accepting new patients
Decatur General Hospital Past Accepting new patients

Locations

1222 Somerville Rd SE
Decatur, AL 35601
Phone (256) 341-0152

1115 Beltline Rd SE
Ste 400
Decatur, AL 35601
Phone (256) 898-3004

307 Main St SW
Hanceville, AL 35077
Phone (256) 352-0188

222 Arkadelphia Rd NE
Hanceville, AL 35077
Phone (256) 352-4767

111 Brooklyn Rd
Holly Pond, AL 35083
Phone (256) 451-1250

1 Hospital Dr SW
Huntsville, AL 35801
Phone (256) 429-4000

4810 Whitesport Cir SW
Ste 201
Huntsville, AL 35801
Phone (256) 429-5248

12205 County Line Rd
Ste B
Madison, AL 35758
Phone (256) 325-4365

300 Hughes Rd
Ste G2
Madison, AL 35758
Phone (256) 542-0230

2343 2nd Ave E
Oneonta, AL 35121
Phone (205) 625-3332

2345 2nd Ave E
Ste B
Oneonta, AL 35121
Phone (205) 625-3332

27550 State Highway 75
Ste 105
Oneonta, AL 35121
Phone (205) 625-4930

506 Harley St
Scottsboro, AL 35768
Phone (256) 259-1234

Interoperability endpoints

  • Direct secure messaging: jwillis@2212.securemail.prognocis.com
  • FHIR API: https://api.platform.athenahealth.com/17774/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/3038/brand/1/csg/64/fhir/r4

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1275831703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585919",
            "telephone_number": "256-325-9111",
            "fax_number": "256-325-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585919",
            "telephone_number": "256-325-9111",
            "fax_number": "256-325-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JOHN",
        "middle_name": "EVAN",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-08",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-114309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.