Wayne S Willis MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WAYNE S WILLIS MD LLC

Practice address

3111 Peggy Bond Dr
Pensacola, FL 32504-5018

Phone

(850) 438-9755

Fax

(850) 438-0699

NPI assigned

Feb 1, 2006

Last updated

Feb 5, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wayne S. Willis, MDNPI 1003880667

Title

President

Phone

(850) 438-9755

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wayne S Willis, MD

  • Family Medicine Physician
  • Pensacola, FL
  • NPI 1003880667
  NPD (past) Authorized official
• Lanway Hillary Ling, MD

  • Family Medicine Physician
  • Pensacola, FL
  • NPI 1932173598
  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360022400000",
    "number": "1528039021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 PEGGY BOND DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045018",
            "telephone_number": "850-438-9755",
            "fax_number": "850-438-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 PEGGY BOND DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045018",
            "telephone_number": "850-438-9755",
            "fax_number": "850-438-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE S WILLIS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2013-02-05",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-438-9755",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274727800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "98793",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Watts, MSW
• Linda Watts, ARNP
• Monica Watts, CBGT,
• Wave Medical Florida LLC
• Kevin Waymire, LMFT, RPT
• Wayne S. Willis MD LLC
• We Care Transportation Service LLC
• Christine Kennedy Weakley, PA
• Walter Marion Weakley III, LMT, MMT
• Sylvia Weatherspoon, HHA

• Family Medicine Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; 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.