Amique Amoy Willis

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

4615 University Dr
Durham, NC 27707-3458

Phone

(188) 835-1828

NPI assigned

Feb 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Esd PT OT and SLP PLLCGroup PAC ID 5991044125, 77 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Esd PT OT & SLP PLLC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1003383308

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1447905468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 UNIVERSITY DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073458",
            "telephone_number": "188-835-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 UNIVERSITY DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073458",
            "telephone_number": "188-835-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "AMIQUE",
        "middle_name": "AMOY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA STUDENT BLUE",
            "identifier": "UUI103212601",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen L Williamson, ANP
• Louise Margaret Williamson
• Cinthia M. Williford, DPT
• Margaret Williford, M.D.
• Alecia Willis, PH.D.
• Benjamin Sheppard Willis, LCSW-A
• Charles Steadman Willis III, D.M.D.
• Charles Steadman Willis, DDS
• Christine Willis
• David Dawson Willis, MD

• Occupational Therapist in Durham, NC
• Providers in Durham, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.