Jason S. Willis, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

N9146 Issued in TX

Practice address

4770 Regent Blvd
Irving, TX 75063-2445

Phone

(972) 934-4300

NPI assigned

Jun 11, 2007

Last updated

Jan 14, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• MCD Pathology LLP

  • Anatomic Pathology & Clinical Pathology Physician
  • Dallas, TX
  • NPI 1114959665
  Medicare reassignment NPD

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1487857983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3213 DREXEL DRIVE",
            "address_2": "SUITE 400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75205",
            "telephone_number": "214-437-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 REGENT BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632445",
            "telephone_number": "972-934-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JASON",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "N9146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vadeisha Williams, LCSW
• Vanessa P Williams, DDS
• David A Willingham, O.D.
• Willis L Starnes MD PHD
• Christina Suzanne Willis, MS SLP-INTERN
• Ariel Marie Wilson, M.S., CCC-SLP
• Carolyn Fern Wilson, DDS MSD
• Christopher Reshaud Wilson, PTA
• Clara Wilson
• Erin Wilson

• Anatomic Pathology & Clinical Pathology Physician in Irving, TX
• Providers in Irving, TX by specialty
• Anatomic Pathology & Clinical Pathology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.