Phylis Willis, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN161240 Issued in GA

Practice address

910 5TH St.
Suite a
Cordele, GA 31015-3254

Phone

(229) 276-2185

Fax

(229) 276-2186

NPI assigned

Jul 1, 2015

Sex

Female

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 GA

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crisp Regional Hospital IncGroup PAC ID 5991616336, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Crisp Regional Hospital Hospital, Cordele, GA, CCN 110104

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: phyllis.willis@crispregional.gadirect.net

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.

• Crisp Regional Hospital Inc

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649
  Medicare reassignment Care Compare group NPD
• Crisp Regional Hospital, Inc

  • Long Term Care Pharmacy
  • Cordele, GA
  • NPI 1679836142
  NPD

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

• Crisp Regional Hospital Inc

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649
  Care Compare affiliation

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1497138911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 5TH STREET",
            "address_2": "SUITE A",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153254",
            "telephone_number": "229-276-2185",
            "fax_number": "229-276-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 5TH ST.",
            "address_2": "SUITE A",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153254",
            "telephone_number": "229-276-2185",
            "fax_number": "229-276-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "PHYLIS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN161240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassie Quick Whiggum, CF-SLP
• Ryan Wilkerson
• Laura Jenkins Williams, PHARM D
• Mary Lynn Williams, NP-C
• Robert Williams
• Wiley Wilson, DO
• Christian Wohlfeld
• Feai Voon Wong, MS, RD, LD
• Brittany A Wood, FNP-C
• Consuela Katrice Woodson

• Family Nurse Practitioner in Cordele, GA
• Providers in Cordele, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.