Amy Willbanks, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2011039626 Issued in MO

Practice address

600 Medical Dr
Wentzville, MO 63385-3426

Phone

(636) 332-8482

NPI assigned

Mar 14, 2012

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• SSM St. Charles Clinic Medical Group, Inc.

  • Family Medicine Physician
  • Saint Charles, MO
  • NPI 1811932973
  NPD (past)

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1417222175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CRIMSON OAKS CT",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633674593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MEDICAL DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853426",
            "telephone_number": "636-332-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLBANKS",
        "first_name": "AMY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-14",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2011039626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Martin Wiegand, ATC, LAT
• Karen Marie Wiethuchter, MA, LPC
• Kacie-Lynn Wigger
• Amy Christeen Willard, PLPC
• Lori D Willard
• William E. Schultz, OD LLC
• Angela C Williams, WHNP-BC
• Elicia Williams, NURSE PRACTITIONER
• Janie Renee Williams, EDS, PLPC
• Daniel J Wilmes, D.D.S.

• Family Nurse Practitioner in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.