Individual provider Active NPI

Brenda Lynn Willis, FNP

  • Family Nurse Practitioner
  • Leesville, LA
National Provider Identifier
1306461660
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
213832 Issued in LA
Practice address
919 S 10TH St
Leesville, LA 71446-4613
Phone
(337) 239-2207
Fax
(337) 239-2583
NPI assigned
Jun 12, 2020
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 213832 LA Primary

Addresses

Primary practice location

919 S 10TH St
Leesville, LA 71446-4613

Mailing address

7946 Highway 10
Pitkin, LA 70656-4567
Phone (337) 208-1680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20200929000020 LA Practitioner - Nurse Practitioner 6901225705 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Physical Therapy Services of West Louisiana IncGroup PAC ID 0446388763, 92 clinicians
Professional Pediatrics, LLCGroup PAC ID 5698847317, 5 clinicians

Practice addresses (Care Compare)

301 W Fertitta Blvd
Suite 4
Leesville, LA 71446-4665
Phone (337) 238-9931

919 S 10TH St
Leesville, LA 71446-4613
Phone (337) 239-2207

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.68 of 100Reported as group
Quality
49.78
Improvement activities
40
Cost
71.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Pediatrics, LLC CurrentSince Aug 1, 2025 Accepting new patients
West State Orthopedics & Sport Medicine CurrentSince Jun 1, 2021 Accepting new patients
SPG Capital Partners, LLC PastSince Jun 1, 2021 Accepting new patients
Deer Creek Imaging Center PastSince Jun 1, 2020 Accepting new patients

Locations

908 S 10th St
#A
Leesville, LA 71446
Phone (337) 392-2300

919 S 10th St
Leesville, LA 71446
Phone (337) 239-2207

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1306461660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7946 HIGHWAY 10",
            "city": "PITKIN",
            "state": "LA",
            "postal_code": "706564567",
            "telephone_number": "337-208-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 S 10TH ST",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464613",
            "telephone_number": "337-239-2207",
            "fax_number": "337-239-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "BRENDA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "213832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.