Individual provider Active NPI

Willie Joseph Hillson, M.D.

  • Specialist
  • Augusta, GA
National Provider Identifier
1366481723
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G20737 Issued in GA
Practice address
2045 Gordon Hwy
Suite B
Augusta, GA 30909-5496
Phone
(706) 736-3210
Fax
(706) 736-2674
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G20737 GA Primary

Addresses

Primary practice location

2045 Gordon Hwy
Suite B
Augusta, GA 30909-5496

Mailing address

2045 Gordon Hwy
Suite B
Augusta, GA 30909-5496
Phone (706) 736-3210

Other identifiers 1

IdentifierTypeStateIssuer
00180155BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20090617000609 GA Practitioner - Internal Medicine 5890845507 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G20737GAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Beulah Grove Community Resource Center CurrentSince Jul 22, 2011 Accepting new patients
Palmetto Infusion Services LLC Past Accepting new patients
Augusta Primary Care Services LLC Past Accepting new patients

Locations

1448 Linden St
Augusta, GA 30901
Phone (706) 828-2374

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366481723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 GORDON HWY",
            "address_2": "SUITE B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309095496",
            "telephone_number": "706-736-3210",
            "fax_number": "706-736-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 GORDON HWY",
            "address_2": "SUITE B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309095496",
            "telephone_number": "706-736-3210",
            "fax_number": "706-736-2674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLSON",
        "first_name": "WILLIE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "G20737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00180155B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.