NPIMap

Individual provider Active NPI

Winston James Willis

  • Emergency Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1477832251
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
006272 Issued in AZ
Practice address
1024 S Lemay Ave
Fort Collins, CO 80524-3929
Phone
(970) 495-7000
Fax
(303) 306-7753
NPI assigned
Aug 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 006272 AZ Primary

Addresses

Primary practice location

1024 S Lemay Ave
Fort Collins, CO 80524-3929

Mailing address

PO Box 912215
Denver, CO 80291-2215
Phone (303) 306-7101

Other names 1

  • Winston James Willis Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160120000581 CO Practitioner - Emergency Medicine 3678797818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of the Rockies, PCGroup PAC ID 0345232492, 76 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Poudre Valley Hospital
Fort Collins, CO 80524-3929
Phone (970) 495-7000

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131

Merit-based Incentive Payment System (MIPS)

Final score
93.04 of 100Reported as group
Quality
87.35
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
006272AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of the Rockies, PC Emergency Medicine CurrentSince Jan 17, 2016 Accepting new patients
Emergency Physicians of the Rockies, PC Emergency Medicine CurrentSince Jan 17, 2016 Accepting new patients

Locations

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

Organizations & group practices 2

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1477832251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912215",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802912215",
            "telephone_number": "303-306-7101",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 S LEMAY AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243929",
            "telephone_number": "970-495-7000",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "WINSTON",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-10",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "006272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WINSTON",
            "last_name": "WILLIS",
            "middle_name": "JAMES",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.