James O'Bryan Willey, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2155 Issued in OH

Practice address

3737 Southern Blvd
Suite 2100
Kettering, OH 45429-1225

Phone

(937) 433-5309

Fax

(937) 298-0287

NPI assigned

Aug 11, 2006

Last updated

Nov 13, 2020By the provider in NPPES

Sex

Male

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 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239

Merit-based Incentive Payment System (MIPS)

Final score

81.34 of 100Reported as group

Quality

63.67

Promoting interoperability

100

Improvement activities

40

Cost

74.14

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865
  Medicare reassignment Care Compare group
• Alliance Physicians Inc

  dba Kettering Health Medical Group

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  Medicare reassignment NPD
• Alliance Physicians Inc

  dba Kettering Reproductive Medicine

  • Reproductive Endocrinology Physician
  • Kettering, OH
  • NPI 1578824033
  NPD
• Far Oaks Orthopedists, Inc

  • Orthopaedic Surgery Physician
  • Centerville, OH
  • NPI 1609887702
  NPD (past)

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

• Kettering Medical Center

  dba Kettering Health Miamisburg

  • General Acute Care Hospital
  • Miamisburg, OH
  • NPI 1316966518
  Care Compare affiliation

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1326059692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 SOUTHERN BLVD STE 2100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291285",
            "telephone_number": "937-433-5309",
            "fax_number": "937-298-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 SOUTHERN BLVD",
            "address_2": "SUITE 2100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291225",
            "telephone_number": "937-433-5309",
            "fax_number": "937-298-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEY",
        "first_name": "JAMES",
        "middle_name": "O'BRYAN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50002155",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "2155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "349758",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00182934",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "P00182934",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilley24358@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3737 Southern Blvd",
            "address_2": "Suite 2100",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3737 Southern Blvd",
            "address_2": "Suite 2100",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah J Wildermuth, MSW, LSW, CCTP II
• Meghan Elizabeth Wilke
• Shelby Lynn Wilkerson
• Taylor Wilkerson
• Thomas B Wilkinson, LPCC, LICDC
• William E Coyne DDS Inc
• Debra Sue Williamitis
• Daniel Bryan Williams
• Julie C Williams, PA
• Lora Lynn Williams

• Surgical Physician Assistant in Kettering, OH
• Providers in Kettering, OH by specialty
• Surgical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.
• 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.

Verify at the official NPI Registry.