Beau Willis, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

307117 Issued in LA

Practice address

2520 Harvard Ave FL 1
Metairie, LA 70001-1172

Phone

(504) 454-3004

Fax

(504) 454-3075

NPI assigned

Apr 15, 2014

Sex

Male

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 LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Barry University School of Podiatric Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gulf South Foot and Ankle LLCGroup PAC ID 4082885272, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3187/brand/1/csg/1/fhir/r4

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.

• Gulf South Foot & Ankle, LLC

  • Podiatrist
  • Metairie, LA
  • NPI 1649563008

  Primary Podiatric Medicine

  Medicare reassignment Care Compare group NPD
• Nicholas D Pappas III MD LLC

  • Orthopaedic Hand Surgery Physician
  • Metairie, LA
  • NPI 1639885940
  NPD

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1396164679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 HARVARD AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011172",
            "telephone_number": "504-454-3004",
            "fax_number": "504-454-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 HARVARD AVE FL 1",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011172",
            "telephone_number": "504-454-3004",
            "fax_number": "504-454-3075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37292 Market Place Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Prairieville",
            "state": "LA",
            "postal_code": "707693487",
            "country_code": "US",
            "telephone_number": "225-744-3668",
            "fax_number": "225-744-3669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "71121 Highway 21 Ste A",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704337176",
            "country_code": "US",
            "telephone_number": "985-809-1464",
            "fax_number": "985-888-1981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "BEAU",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "LA",
            "license": "307117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zeta Williams
• Krystal J Williamson
• Monique Williamson
• Renee Williamson
• Jessica Williford
• Fred Spencer Willis III
• Joseph Willis, M.D.
• Mykayla Willis
• Taylor Elise Willis II
• Chasity Willmouth, RN

• Foot & Ankle Surgery Podiatrist in Metairie, LA
• Providers in Metairie, LA by specialty
• Foot & Ankle Surgery Podiatrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.
• 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.