Denise Boyd Willis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110001909 Issued in VA

Practice address

5303 Plaza Dr
Suite 101
Hopewell, VA 23860-7331

Phone

(804) 458-2006

Fax

(804) 458-3629

NPI assigned

Dec 15, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1326024076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 SCHOONER LANE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "23860",
            "telephone_number": "804-892-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5303 PLAZA DR",
            "address_2": "SUITE 101",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238607331",
            "telephone_number": "804-458-2006",
            "fax_number": "804-458-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "DENISE",
        "middle_name": "BOYD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0110001909",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA STATE MEDICAL LICENSE",
            "identifier": "0110001909",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007691084",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Willhite
• William C Henry DDS PC
• Nkese Williams-Hayes, PMH/NP
• Betty Williams
• Joyce Walean Williams
• Diana L Willis, RPH
• Christine Wilson
• Jessica Amber Wilson, COTA
• Wise Journey LTD (Wise Journey Home Care and Living Assistance)
• Thomas Wright

• Medical Physician Assistant in Hopewell, VA
• Providers in Hopewell, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.