John A. Willis, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

15995 Issued in WV

Practice address

1538 Kanawha Blvd E
Charleston, WV 25311-2435

Phone

(304) 344-3457

Fax

(304) 344-3480

NPI assigned

Jun 13, 2005

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

Other identifiers 13

Medicare fee-for-service enrollment

Enrolled in WV, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Diagnostic Radiology

Education

West Virginia University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pikeville Medical Center Hospital, Pikeville, KY, CCN 180044

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Pikeville Medical Center Inc.

  • Multi-Specialty Clinic/Center
  • Pikeville, KY
  • NPI 1528195864
  Medicare reassignment Care Compare group NPD
• Associated Radiologists, Inc.

  • Diagnostic Radiology Physician
  • Charleston, WV
  • NPI 1649275728
  Medicare reassignment NPD
• THS Physician Partners Inc

  • Internal Medicine Physician
  • South Charleston, WV
  • NPI 1871866806
  Medicare reassignment NPD
• Pikeville Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Cheyenne, WY
  • NPI 1891599502
  NPD
• Charleston Radiation Therapy Consultants PLLC

  • Radiation Oncology Physician
  • Charleston, WV
  • NPI 1942208145
  NPD (past)
• Greenbrier Clinic, Inc.

  • Internal Medicine Physician
  • White Sulphur Springs, WV
  • NPI 1043258783

  Diagnostic Radiology

  NPD (past)
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pikeville Medical Center Inc

  • General Acute Care Hospital
  • Pikeville, KY
  • NPI 1285621623
  Care Compare affiliation

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1437153939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11137",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253391137",
            "telephone_number": "304-344-3457",
            "fax_number": "304-344-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1538 KANAWHA BLVD E",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253112435",
            "telephone_number": "304-344-3457",
            "fax_number": "304-344-3480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JOHN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WV",
            "license": "15995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "550516458",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64942089",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0828199",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0120054000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DOL & US POSTAL COMP",
            "identifier": "151237200",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRICKSTREET INSURANCE",
            "identifier": "E67388",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "0130753",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "020011800",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14175",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARELINK & CARELINK PEIA",
            "identifier": "14193",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACORDIA NATIONAL PEIA",
            "identifier": "550516458",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM BLUE & MS BC BS",
            "identifier": "001325206",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP FEIN #",
            "identifier": "55-0516458",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Willis, CRNA
• Angela Willis
• Ernest Willis
• Ja'Nesty Willis
• Jason Willis
• Nakyra Willis
• Virginia Willis
• Jasmine Willman
• Edward Wills
• Kimberly Wills

• Diagnostic Radiology Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Diagnostic Radiology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.