Active NPI
Robert Grant Willis, M.D.
- Surgery Physician
- Charlotte, NC
National Provider Identifier
1295268829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 226854
- Practice address
- 1000 Blythe Blvd
Charlotte, NC 28203-5812 - Phone
- (334) 590-0762
- NPI assigned
- Apr 11, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 93092 | SC | |
| Surgery Physician | 208600000X | 226854 | NC | Primary |
Addresses
Primary practice location
1000 Blythe Blvd
Charlotte, NC 28203-5812
Mailing address
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (334) 590-0762
Other practice location 1
317 Saint Francis Dr Ste 340
Greenville, SC 29601-3914
Phone (864) 255-1317
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Thoracic Surgery
- Education
- University of South Alabama College of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Saint Francis Dr
Greenville, SC 29601-3955
Phone (513) 853-8520
317 Saint Francis Dr
Suite 120
Greenville, SC 29601-3900
Phone (864) 516-1170
317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901
Hospital & facility affiliations
- Interim Healthcare of the Upstate
- St Francis-Downtown
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary artery bypass graft (CABG) | 42 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 226854 | NC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Secours Medical Group Greenville Specialty Care LLC | Surgery | Current | Accepting new patients |
| Bon Secours Medical Group Greenville Specialty Care LLC | Current | Accepting new patients |
Locations
317 Saint Francis Dr
Ste 340
Greenville, SC 29601
Phone (864) 255-1834
317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901
Interoperability endpoints
- rwillis2667185@direct.bsmhealth.org
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 and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Greenville, SC
- NPI 1821679580
Surgery
-
- Orthopaedic Surgery Physician
- Fountain Inn, SC
- NPI 1760361174
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Greenville, SC
- NPI 1750897609
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1730123175
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1467496802
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1023418035
-
- General Acute Care Hospital
- Greenville, SC
- NPI 1376899856
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724112000000",
"number": "1295268829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812",
"telephone_number": "334-590-0762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035812",
"telephone_number": "334-590-0762"
}
],
"practiceLocations": [
{
"address_1": "317 Saint Francis Dr Ste 340",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "SC",
"postal_code": "296013914",
"country_code": "US",
"telephone_number": "864-255-1317",
"fax_number": "877-591-6931",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIS",
"first_name": "ROBERT",
"middle_name": "GRANT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-11",
"last_updated": "2024-08-20",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "SC",
"license": "93092",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "226854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.