Angela Soyad Willis, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704307286 Issued in MI

Practice address

43455 Schoenherr Rd Ste 2
Sterling Heights, MI 48313-1972

Phone

(586) 726-4823

NPI assigned

Nov 13, 2018

Sex

Female

Sole proprietor

No

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 MI

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angelawillis@spmgsh.allscriptsdirect.net

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.

• Silver Pine Medical Group PLC

  • Family Medicine Physician
  • Sterling Heights, MI
  • NPI 1639105695
  Medicare reassignment NPD
• Bayside Family Medicine Chesterfield PC

  • Family Medicine Physician
  • Chesterfield, MI
  • NPI 1790018315
  NPD (past)

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1366911927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15589 WINTERPARK DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480443877",
            "telephone_number": "586-872-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43455 SCHOENHERR RD STE 2",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131972",
            "telephone_number": "586-726-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ANGELA",
        "middle_name": "SOYAD",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704307286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Williams
• Shantia Williams
• Tiara Williams
• Kristen Williamson
• Victoria Williamson
• Willliam Beaumont Hospital
• Shzil Willoughby
• Alexander Wills
• Bianca Wilson, LMSW, SSW
• Binta Victoria Wilson

• Adult Health Nurse Practitioner in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.