Marshall Ray Willis, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

011377 Issued in TN

Practice address

1000 Highway 28
Grandview Medical Center
Jasper, TN 37347-3638

Phone

(423) 942-1674

Fax

(423) 942-9982

NPI assigned

Sep 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Heritage Radiology, PC

  • Diagnostic Radiology Physician
  • Jasper, TN
  • NPI 1730230210
  NPD (past)

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1528054293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 128",
            "address_2": "195 MYERS AVE",
            "city": "GUILD",
            "state": "TN",
            "postal_code": "373400128",
            "telephone_number": "423-942-1674",
            "fax_number": "423-942-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HIGHWAY 28",
            "address_2": "GRANDVIEW MEDICAL CENTER",
            "city": "JASPER",
            "state": "TN",
            "postal_code": "373473638",
            "telephone_number": "423-942-1674",
            "fax_number": "423-942-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MARSHALL",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "011377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3808477",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valley Imaging Partners, P.C.
• Valley Medical Care LLC
• Valley Medical Imaging
• Christopher Brian Walls, NP-C
• Pamela Louise West, APN
• Benjamin M Willy, ATC
• Janet Elaine Winnie, RN, BS
• Melanie Ruth Wortman
• Jana Zimmerman

• Diagnostic Radiology Physician in Jasper, TN
• Providers in Jasper, TN by specialty
• Diagnostic Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.