Active NPI
Jeffrey Timothy Willsey, CNMT
- Nuclear Medicine Technology Radiologic Technologist
- Dayton, OH
National Provider Identifier
1437374808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Medicine Technology Radiologic Technologist
- License
- 016234
- Practice address
- 4100 W 3Rd St
Dayton, OH 45428-9000 - Phone
- (937) 268-6511
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Medicine Technology Radiologic Technologist | 2471N0900X | N2546923 | OH | |
| Nuclear Medicine Technology Radiologic Technologist | 2471N0900X | 016234 | OH | Primary |
Addresses
Primary practice location
4100 W 3Rd St
Dayton, OH 45428-9000
Mailing address
135 Lodewood Dr
Centerville, OH 45458
Phone (937) 439-0391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016234 | OH | MD | Nuclear Medicine Technology Radiologic Technologist |
| N2546923 | OH | MD | Nuclear Medicine Technology Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437374808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 LODEWOOD DR",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "45458",
"telephone_number": "937-439-0391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 W 3RD ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454289000",
"telephone_number": "937-268-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLSEY",
"first_name": "JEFFREY",
"middle_name": "TIMOTHY",
"name_prefix": "Mr.",
"credential": "CNMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2471N0900X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Nuclear Medicine Technology",
"state": "OH",
"license": "N2546923",
"primary": false
},
{
"code": "2471N0900X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Nuclear Medicine Technology",
"state": "OH",
"license": "016234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.