Adam Matthew Willis, M.D.,PH.D.

Primary specialty

Neurocritical Care PhysicianTaxonomy code 2084A2900X

License

R1322 Issued in TX

Practice address

3551 Roger Brooke Dr
Department of Neurology
Fort Sam Houston, TX 78234

Phone

(210) 916-2203

NPI assigned

May 1, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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, Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: awillis1397828@direct.hopkinsmedicine.org

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1508124272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR DEPT OF",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "DEPARTMENT OF NEUROLOGY",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-916-2203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Bergquist Dr",
            "address_2": "Internal Medicine Clinic",
            "address_purpose": "LOCATION",
            "city": "Lackland A F B",
            "state": "TX",
            "postal_code": "782369907",
            "country_code": "US",
            "telephone_number": "210-292-7805",
            "fax_number": "210-292-7868",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Bergquist Dr",
            "address_2": "Internal Medicine Clinic",
            "address_purpose": "LOCATION",
            "city": "Lackland A F B",
            "state": "TX",
            "postal_code": "782369907",
            "country_code": "US",
            "telephone_number": "210-292-7805",
            "fax_number": "210-292-7868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ADAM",
        "middle_name": "MATTHEW",
        "credential": "M.D.,PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-01",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101254958",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "TX",
            "license": "R1322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Keeney Williams, DPT
• Michelle Renee Williams, M.D.
• Samuel Williams, ARNP
• Tennille Williams, FNP
• Theresa Howell Williams, MD
• Pamelia Fowler Willis, PH.D.
• Tina Wilson-Pifer, LPTA
• David Joseph Wilson, MD, FAAOS, FAOA
• Diana Jean Wilson
• Dwayne Wilson, M.D.

• Neurocritical Care Physician in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Neurocritical Care Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.