Margaret Anne Willis, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

3432 Issued in MN

Practice address

800 W College Ave
Saint Peter, MN 56082-1485

Phone

(909) 680-0076

NPI assigned

Jan 19, 2018

Last updated

Mar 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Maggie Willis Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1508374877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ROW APT 208",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560822000",
            "telephone_number": "909-680-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W COLLEGE AVE",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821485",
            "telephone_number": "909-680-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MARGARET",
        "middle_name": "ANNE",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-19",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "3432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAGGIE",
            "last_name": "WILLIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shane Earl Wernsing, M.D.
• Mary Elizabeth Westby, ATC
• Peter Lynn Westre, RN CNP
• Bethany Whittier, D.D.S.
• Jacqueline Willard, LADC
• Melanie Jean Wurtzberger
• Scott Denis Zeigler, BS PHARM
• Mitchell H Ziemke, PH.D., LP
• Anoria Zuehlke

• Athletic Trainer in Saint Peter, MN
• Providers in Saint Peter, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.