Willow Wellness Center, P.a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WILLOW WELLNESS CENTER, P.A.

Practice address

820 E Front St
Tyler, TX 75702-8326

Phone

(903) 596-0602

Fax

(903) 596-0620

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Angela Nell Smith, M.D.NPI 1740287838

Title

President

Phone

(903) 596-0602

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angela N Smith, M.D.

  • Internal Medicine Physician
  • Tyler, TX
  • NPI 1740287838
  Medicare reassignment Care Compare group Authorized official
• Kimeshia Nicole Johnson, FNP-C

  • Nurse Practitioner
  • Tyler, TX
  • NPI 1699928655
  Medicare reassignment Care Compare group NPD
• Sheleta Necole Lewis, FNP-C

  • Family Nurse Practitioner
  • New York, NY
  • NPI 1639511793
  NPD
• Brittani Nicole Hernandez, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Bullard, TX
  • NPI 1295542546
  NPD (past)
• La'Mesa Hunter

  • Family Nurse Practitioner
  • Tyler, TX
  • NPI 1457855637
  NPD (past)
• Donna Lachelle Jackson

  • Nurse Practitioner
  • Tyler, TX
  • NPI 1114531217
  NPD (past)
• Zekeya V Lofton, NP

  • Family Nurse Practitioner
  • Sunnyvale, TX
  • NPI 1578582987
  NPD (past)
• Maria Teresa Ramirez-Atamoros, MD

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1861652083
  NPD (past)
• Maria Marsha Ratliff, FNP-C

  • Family Nurse Practitioner
  • Denton, TX
  • NPI 1225419575
  NPD (past)
• Adriana Sanders, PA

  • Physician Assistant
  • Jacksonville, TX
  • NPI 1811698806
  NPD (past)
• Comesha S Talley, FNP

  • Family Nurse Practitioner
  • Longview, TX
  • NPI 1427827906
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1346346335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E FRONT ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028326",
            "telephone_number": "903-596-0602",
            "fax_number": "903-596-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E FRONT ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028326",
            "telephone_number": "903-596-0602",
            "fax_number": "903-596-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW WELLNESS CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "NELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-596-0602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031016101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammye Willis, APRN, FNP-C
• Tyler Willis, M.D.
• Anna Beth Willits
• Willow Bend Center
• Willow Counseling Center
• James M Willtrout
• Wilson Chiropractic and Acupuncture PLLC (East Texas Family Chiropractic)
• Wilson Renfroe, PSYD, PLLC
• Alexander Wilson, PT, DPT
• Alyssa J Wilson, RBT

• Internal Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.