Lauren K Willis, M.D.

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

55979 Issued in MT

Practice address

2835 Fort Missoula Rd BLDG 3
Missoula, MT 59804-7423

Phone

(406) 721-5600

Fax

(406) 721-3907

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT

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 Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwillis825697@wm.providencedirect.org

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.

• Western Montana Clinic PC

  • Multi-Specialty Clinic/Center
  • Missoula, MT
  • NPI 1942253182
  Medicare reassignment NPD
• Western Montana Clinic PC

  • Clinical Medical Laboratory
  • Missoula, MT
  • NPI 1740364017
  NPD

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1457393357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7609",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598077609",
            "telephone_number": "406-721-5600",
            "fax_number": "406-721-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 FORT MISSOULA RD BLDG 3",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047423",
            "telephone_number": "406-721-5600",
            "fax_number": "406-721-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "LAUREN",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101222038",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MT",
            "license": "55979",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MT",
            "license": "55979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690603L",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005830427",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwillis825697@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2835 Fort Missoula Rd Bldg 3",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598047423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tami Marie Williams, LCPC
• Tanner Williams, DPT
• Celeste Willis
• Jeff R Willis, M.D.
• Jordan Willis, RPH
• John A. Willoughby, MD
• Willowbrook Counseling PLLC
• Krista O Wills, MT,SM(ASCP)CLS
• Gary J Willstein, MD
• David Lee Wilson, M.D.

• Pediatric Gastroenterology Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Pediatric Gastroenterology Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.