Edwin Enrique Villarreal, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

63221 Issued in TN

Practice address

541 Historic Hwy 441-N
Demorest, GA 30535-4528

Phone

(770) 219-7078

Fax

(770) 219-7365

NPI assigned

May 28, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Edwin Villarreal Mazzilli Other name

Medicare fee-for-service enrollment

Enrolled in GA, AL, TN3 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 3

Specialty

Internal Medicine

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Houston County Healthcare Authority 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edwin.villarreal@direct.baptistfirst.org
• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: evillarreal68463@southeasthealth.direct-ci.com

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.

• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606

  AL, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385

  AL, Hospitalist

  Medicare reassignment NPD
• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212

  GA, Internal Medicine

  Medicare reassignment NPD
• App of Tennessee HM, PLLC

  • Hospitalist Physician
  • Shelbyville, TN
  • NPI 1396160768

  Hospitalist, TN

  Medicare reassignment NPD
• Capstone Health Services Foundation PC

  • Family Medicine Physician
  • Tuscaloosa, AL
  • NPI 1740397751

  AL

  Medicare reassignment NPD
• Flowers HB Medical Services LLC

  • Emergency Medicine Physician
  • Dothan, AL
  • NPI 1972283828

  AL, Hospitalist

  Medicare reassignment NPD
• Nes Tennessee Inc

  • Emergency Medicine Physician
  • Montgomery, AL
  • NPI 1437606605

  AL

  Medicare reassignment NPD
• Oak Mountain Group Services, LLC

  • Hospitalist Physician
  • Birmingham, AL
  • NPI 1366840761

  AL, Hospitalist

  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  Internal Medicine, TN

  Medicare reassignment NPD
• Whatley Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Tuscaloosa, AL
  • NPI 1063422756

  AL

  Medicare reassignment NPD
• Houston County Healthcare Authority

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  Care Compare group NPD (past)
• Houston County Healthcare Authority

  • Clinical Medical Laboratory
  • Dothan, AL
  • NPI 1114161601
  Care Compare group

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

• Houston County Healthcare Authority

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1447418397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-535-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 HISTORIC HWY 441-N",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "305354528",
            "telephone_number": "770-219-7078",
            "fax_number": "770-219-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "EDWIN",
        "middle_name": "ENRIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-28",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "63221",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "066663",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "066663",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDWIN",
            "last_name": "MAZZILLI",
            "middle_name": "VILLARREAL",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Nancy M Watson, M.D.

• All providers in Demorest, GA
• Hospitalist Physician in Georgia

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