Courtney Willis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

318800 Issued in NY

Practice address

391 Myrtle Ave Ste 3B
Albany, NY 12208-3835

Phone

(518) 262-5588

NPI assigned

Mar 23, 2019

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

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cwillis30817@albanymed.direct-ci.com

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.

• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1497921688

  Pediatrics

  Medicare reassignment NPD
• Albany Medical College

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD
• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1386689248
  NPD
• Albany Medical College

  • Physical Medicine & Rehabilitation Physician
  • Albany, NY
  • NPI 1629008537

  Pediatrics

  NPD
• Albany Medical College

  • Pediatrics Physician
  • Albany, NY
  • NPI 1750315636
  NPD

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

{
    "created_epoch": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1326508490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 MYRTLE AVE STE 3B",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083835",
            "telephone_number": "518-262-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 MYRTLE AVE STE 3B",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083835",
            "telephone_number": "518-262-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "COURTNEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "318800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca L Williams, OTA
• Thomas Williams, MD
• Tyleia J Williams
• Vikki Williams, NYCPS
• Lindsay Williamson
• Linda Ann Willis, RN
• Tanika Renee Willis
• Willow Core Logistics
• Willow Tree Psychological Services PLLC
• Sonam Ben Willow, LMSW

• Pediatrics Physician in Albany, NY
• Providers in Albany, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.