Misty Lynn Willis, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

337781 Issued in NY

Practice address

556 Clinton Ave S
Rochester, NY 14620-1105

Phone

(585) 442-8422

NPI assigned

Feb 15, 2013

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/

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.

• Niagara Falls Memorial Medical Center

  • General Acute Care Hospital
  • Niagara Falls, NY
  • NPI 1285717298
  Medicare reassignment NPD
• Niagara Falls Memorial Medical Center

  • Oncology Clinic/Center
  • Niagara Falls, NY
  • NPI 1144842816
  NPD

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

{
    "created_epoch": "1360886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1437499290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9827 TOBERMORY AVE",
            "city": "CLARENCE",
            "state": "NY",
            "postal_code": "140312509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 CLINTON AVE S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146201105",
            "telephone_number": "585-442-8422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Benwood Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142141761",
            "country_code": "US",
            "telephone_number": "716-986-9199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MISTY",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-15",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel J Williford, M.D.
• Stephanie Mrowka Willing, PA
• Jeffrey A Willis, PA
• Lakeisha Deon Willis
• Lisa Kerri Willis, PHD
• Jennifer Louise Willison, R.N. N.P.
• Allen Paul Willistein, PA
• Sara K Willistein, PA-C
• Erika Williston
• Marissa Willix

• Family Nurse Practitioner in Rochester, NY
• Providers in Rochester, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.