Walter Lewis Willis, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

11440 Issued in MS

Practice address

1314 19TH Ave
Meridian, MS 39301-4116

Phone

(601) 703-9260

Fax

(601) 703-4050

NPI assigned

Jun 22, 2006

Last updated

Nov 9, 2013By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS, TX2 enrollments

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 2

Specialty

Emergency MedicineAlso: Family Practice

Education

University of Mississippi School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WMC Emergency Services LLCGroup PAC ID 5698102465, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Winston Medical Center Hospital, Louisville, MS, CCN 250027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• WMC Emergency Services LLC

  • General Acute Care Hospital
  • Louisville, MS
  • NPI 1336786235
  Medicare reassignment Care Compare group
• Mississippi Band of Choctaw Indians

  dba Choctaw Health Center

  • General Acute Care Hospital
  • Choctaw, MS
  • NPI 1790865780

  TX

  Medicare reassignment NPD
• Mississippi Band of Choctaw Indians

  dba Conehatta Satellite Clinic

  • Federal Public Health Clinic/Center
  • Conehatta, MS
  • NPI 1013092600
  NPD
• Mississippi Band of Choctaw Indians

  dba Bogue Chitto Satellite Clinic

  • Federal Public Health Clinic/Center
  • Philadelphia, MS
  • NPI 1144305731
  NPD
• Mississippi Band of Choctaw Indians

  dba Red Water Satellite Clinic

  • Federal Public Health Clinic/Center
  • Carthage, MS
  • NPI 1275611543
  NPD
• Mississippi Band of Choctaw Indians

  dba Choctaw Health Center Ambulance

  • Ambulance
  • Choctaw, MS
  • NPI 1548358153
  NPD
• Mississippi Band of Choctaw Indians

  dba Choctaw Residential Center Physicians

  • Nursing Facility/Intermediate Care Facility
  • Choctaw, MS
  • NPI 1891965612
  NPD

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

• Winston County Medical Foundation

  dba Winston Medical Center

  • General Acute Care Hospital
  • Louisville, MS
  • NPI 1073597126
  Care Compare affiliation

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383955200000",
    "number": "1346286598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5183",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025183",
            "telephone_number": "601-703-4282",
            "fax_number": "601-703-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014116",
            "telephone_number": "601-703-9260",
            "fax_number": "601-703-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "WALTER",
        "middle_name": "LEWIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2013-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MS",
            "license": "11440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00113996",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sylvia Kay Williams, NP
• Cathy G. Williamson, CNM
• Karleigh Shelton Williamson, DMD
• Russell N Williamson, CRNA
• Robbi La'Tise Willis, PHARMD
• Diana Wilmoth, MD
• Alexis Michelle Wilson
• Dwyla Wilson, LPC-S, NCC
• James P Wilson, M.D.
• Rhonda H Wilson, M.D.

• Emergency Medical Services (Emergency Medicine) Physician in Meridian, MS
• Providers in Meridian, MS by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2013; 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.