Shirley Jean Willis, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

708OD Issued in WV

Practice address

1001 Elizabeth St
Oak Hill, WV 25901-2342

Phone

(304) 465-0447

Fax

(304) 465-1966

NPI assigned

Jul 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• New River Vision Care

  • Optometrist
  • Oak Hill, WV
  • NPI 1548594856
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1427062926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ELIZABETH ST",
            "city": "OAK HILL",
            "state": "WV",
            "postal_code": "259012342",
            "telephone_number": "304-465-0447",
            "fax_number": "304-465-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 ELIZABETH ST",
            "city": "OAK HILL",
            "state": "WV",
            "postal_code": "259012342",
            "telephone_number": "304-465-0447",
            "fax_number": "304-465-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "SHIRLEY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "708OD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3105016000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Williams
• Latasha Williams
• Lea Ann Williams
• Patricia J Williams
• Michelle Willis
• Amber Kay Willoughby, LSW
• Travis McKenzie Wills, D.D.S.
• Abbigail Wilson
• Allison Wilson
• Breanne Wilson

• Optometrist in Oak Hill, WV
• Providers in Oak Hill, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.