Individual provider Active NPI

Susan Elaine Wills, M.D.

  • Family Medicine Physician
  • Sherman, TX
National Provider Identifier
1497794044
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L2057 Issued in TX
Practice address
262 E Evergreen St
Sherman, TX 75090
Phone
(903) 893-5546
Fax
(903) 892-0065
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L2057 TX Primary

Addresses

Primary practice location

262 E Evergreen St
Sherman, TX 75090

Mailing address

262 E Evergreen St
Sherman, TX 75090
Phone (903) 893-5546

Other identifiers 1

IdentifierTypeStateIssuer
8V5390OtherTXBLUECROSS BLUESHIELD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060706000351 TX Practitioner - Family Practice 4385656511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L2057TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wills Family Clinic, P.a. CurrentSince Aug 1, 2006 Accepting new patients
Hillcrest Healthcare Services Inc Past Accepting new patients
Physicians and Allied Health Professionals Group, PA Family Medicine Past Accepting new patients
PBHS Home Health DFW I, Inc Past Accepting new patients

Locations

262 E Evergreen St
Sherman, TX 75090
Phone (903) 484-3668

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1497794044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 E EVERGREEN ST",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "75090",
            "telephone_number": "903-893-5546",
            "fax_number": "903-892-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 E EVERGREEN ST",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "75090",
            "telephone_number": "903-893-5546",
            "fax_number": "903-892-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "SUSAN",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L2057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "8V5390",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

Verify at the official NPI Registry.