Kanye Willis, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

64699 Issued in GA

Practice address

315 Boulevard NE
Suite 555
Atlanta, GA 30312-1200

Phone

(404) 265-4000

NPI assigned

May 29, 2007

Last updated

Nov 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kanye.willis.p172@direct.tenet.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• USA Vascular Center of Decatur LLC

  • Vascular Surgery Physician
  • Decatur, GA
  • NPI 1487133278
  Medicare reassignment NPD
• USA Vein Clinics of Decatur LLC

  • Vascular Surgery Physician
  • Decatur, GA
  • NPI 1912301003
  Medicare reassignment NPD
• Houston Hospitals Inc

  dba Emory Hospital Warner Robins

  • General Acute Care Hospital
  • Warner Robins, GA
  • NPI 1962435792
  NPD
• Pelham Pkwy Professional Medical Services of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1063926962
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1437350527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD NE",
            "address_2": "SUITE 555",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121200",
            "telephone_number": "404-265-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD NE",
            "address_2": "SUITE 555",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121200",
            "telephone_number": "404-265-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KANYE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "64699",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "64699",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Willis
• Hannah Noelle Willis
• Holly Willis, RN
• Julius M Willis Sr.
• Kamili J Willis
• Keniya Willis
• Keysha Nicole Willis, LMSW
• Lacona Rashawn Willis
• Malia Dolores Willis, M.D.
• Maria Willis, FNP-BC

• Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.