Individual provider Active NPI

Emily Willis, CRNP

  • Family Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1457006686
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-157179 Issued in AL
Practice address
50 Medical Park Dr E
Birmingham, AL 35235-3401
Phone
(043) 723-9439
Fax
(904) 212-1618
NPI assigned
Feb 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 1-157179 AL Primary

Addresses

Primary practice location

50 Medical Park Dr E
Birmingham, AL 35235-3401

Mailing address

7751 Belfort Pkwy Ste 120
Jacksonville, FL 32256-6921
Phone (904) 372-3943

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL fax

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20220419001047 AL Practitioner - Nurse Practitioner 4284021452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diabetes Management Partners LLCGroup PAC ID 9436435385, 66 clinicians

Practice addresses (Care Compare)

50 Medical Park Dr E
Birmingham, AL 35235-3401
Phone (904) 372-3943

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes Management Partners LLC CurrentSince Jul 30, 2025 Accepting new patients
Diabetes Management Partners LLC Multi-Specialty CurrentSince Jul 30, 2025 Accepting new patients
Anniston Medical Clinic PC Multi-Specialty CurrentSince Jan 10, 2022 Accepting new patients

Locations

1010 Christine Ave
Anniston, AL 36207
Phone (256) 236-5631

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

50 Medical Park Dr E
Birmingham, AL 35235
Phone (205) 838-3000

7751 Belfort Pkwy
Ste 120
Jacksonville, FL 32256

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1457006686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7751 BELFORT PKWY STE 120",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566921",
            "telephone_number": "904-372-3943",
            "fax_number": "904-212-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEDICAL PARK DR E",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353401",
            "telephone_number": "043-723-9439",
            "fax_number": "904-212-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "EMILY",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-157179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "fax",
            "affiliation": "N",
            "address_1": "1010 Christine Ave",
            "city": "Anniston",
            "state": "AL",
            "country_code": "US",
            "postal_code": "362075782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.