Individual provider Active NPI

Mark D Willingham, MD

  • Anesthesiology Physician
  • Saint Louis, MO
National Provider Identifier
1487068144
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
62763 Issued in AZ
Practice address
1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003
Phone
(314) 362-2330
Fax
(314) 747-1070
NPI assigned
Jun 19, 2014
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 62763 AZ Primary
Anesthesiology Physician 207L00000X 2017017635 MO

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003

Mailing address

660 S Euclid Ave
CB 8054
Saint Louis, MO 63110-1010
Phone (314) 362-2330

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210324002465 AZ Practitioner - Anesthesiology 0042431124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Saint Louis University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Anesthesiology Consultants IncGroup PAC ID 4880591841, 284 clinicians

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612

1500 S Dobson Rd
Suite 101
Mesa, AZ 85202-4722
Phone (480) 412-3577

19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone (623) 879-6100

250 E Dunlap Ave
Phoenix, AZ 85020-2825
Phone (602) 943-2381

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (954) 939-5000

3535 N Scottsdale Rd
Scottsdale, AZ 85251-5625
Phone (480) 882-4365

5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone (602) 865-5555

7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone (480) 882-4000

9003 E Shea Blvd
Scottsdale, AZ 85260-6709
Phone (480) 323-3000

9201 W Thomas Rd
Phoenix, AZ 85037-3332
Phone (623) 327-5047

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017017635MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Anesthesiology Consultants, Inc. Anesthesiology CurrentSince Apr 1, 2021 Accepting new patients
Washington University PastSince Jul 25, 2019 Accepting new patients

Locations

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

645 E Missouri Ave
Ste 300
Phoenix, AZ 85012
Phone (602) 262-8917

9201 W Thomas Rd
Phoenix, AZ 85037
Phone (623) 327-4000

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1487068144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8054",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-2330",
            "fax_number": "314-747-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-362-2330",
            "fax_number": "314-747-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLINGHAM",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "62763",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2017017635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.