Summer Willis, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP140446 Issued in TX

Practice address

705 E Marshall Ave Ste 5000
Longview, TX 75601-5660

Phone

(903) 315-3646

NPI assigned

Apr 10, 2019

Last updated

Jun 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: info@longviewsportsmed.com
• Direct secure messaging: swillis275600@christushealth.direct-ci.net

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.

• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment Care Compare group NPD
• Longview Integrated Medicine PLLC

  dba Longview Spine & Sports Medicine

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Longview, TX
  • NPI 1801302203
  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD

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

• Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1124092036
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1477016095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 E MARSHALL AVE STE 5000",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015660",
            "telephone_number": "903-315-3646",
            "fax_number": "903-230-8056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E MARSHALL AVE STE 5000",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015660",
            "telephone_number": "903-315-3646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Doctor Cir",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756055050",
            "country_code": "US",
            "telephone_number": "903-753-2322",
            "fax_number": "903-234-2979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3133 Good Shepherd Way",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756057921",
            "country_code": "US",
            "telephone_number": "903-315-4422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "SUMMER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP140446",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140446",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@longviewsportsmed.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "2 Doctor Cir",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756055050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyle Alan Willingham, M.D.
• Deborah Willis, R.PH.
• Margaret Willis, RBT
• Selwyn Willis, DPM
• Sheila W Willis, LPC
• Willow Bend Center
• Allessia Wilson, MD
• Amy Ann Wilson, PT
• Cydney Erin Wilson, NP
• Jennifer R Wilson, MT

• Nurse Practitioner in Longview, TX
• Providers in Longview, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.