Willows Nest

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

WILLOWS NEST

Practice address

610 E 7TH St
Charlotte, NC 28202-2923

Phone

(704) 430-1038

NPI assigned

Feb 8, 2018

Organization subpart

No

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

Authorized official

Name

Davion Douglas

Title

Owner

Phone

(704) 430-1038

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1376042002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13724 RIDING HILL AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282134251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022923",
            "telephone_number": "704-430-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWS NEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "DAVION",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-430-1038"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayanna M Willoughby
• Erika Gist Willoughby
• Shauna Lee Willoughby, MSW,
• Willow Residential LLC
• Willow Ridge Assisted Living LLC
• Lisa Wills
• Tanija S Wills
• Marion Ellen Wilm, OTR/L
• Joya D Wilmot
• Wilora Lake Healthcare LLC

• Case Management Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Case Management Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.