Courtney Wille, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.005801RX Issued in OH

Practice address

1900 23Rd St
Cuyahoga Falls, OH 44223-1404

Phone

(330) 563-0618

NPI assigned

Nov 14, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Qualified Emergency Specialists Inc

  • Emergency Medicine Physician
  • Cincinnati, OH
  • NPI 1700872728
  Medicare reassignment

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1356810865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 OAKWOOD AVE",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454192937",
            "telephone_number": "937-546-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 23RD ST",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442231404",
            "telephone_number": "330-563-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLE",
        "first_name": "COURTNEY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005801RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deszaree White
• Mariela G White, MD
• Maureen White
• Matthew Wilcox, DO
• Beth G Wildman, PHD
• Caroline Pejeau Willett, PHD
• Bianca Williams
• Ladonya Sierra Williams
• Renee Ruth Williams, OTR/L
• Stephanie Palmer Williams, L.P.N.

• Physician Assistant in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.