Charles Elmer Willyard III, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20A19161 Issued in CA

Practice address

7370 N Palm Ave
Fresno, CA 93711-5782

Phone

(559) 228-4222

NPI assigned

Mar 25, 2018

Last updated

Oct 13, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

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 Osteopathy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Partners

  • Multi-Specialty Clinic/Center
  • Fresno, CA
  • NPI 1952912420
  Medicare reassignment NPD

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

{
    "created_epoch": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1437654258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7370 N PALM AVE # 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7370 N PALM AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115782",
            "telephone_number": "559-228-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLYARD",
        "first_name": "CHARLES",
        "middle_name": "ELMER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-25",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A19161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Lavell Willis III
• Jessica Rose Willis
• McArthur Shelton Willis IV
• Willow Dental Group
• Willow Sleep Health Dental Group, SE Anderson, DDS Inc.
• Caresse Latreece Wilson-Cotter
• Andrinee Wilson-Tucker
• Abigail Wilson
• Brent Wilson, MD
• Dwayne Wilson

• Internal Medicine Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.