Amos J Willis, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

2015-00049 Issued in NC

Practice address

112 West Woodhill Drive
Nags Head, NC 27959-2795

Phone

(252) 261-8778

Fax

(252) 715-3446

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Ophthalmology

Education

State University of New York Downstate Medical Center, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Coastal Eyes of the Outer Banks PLLC

  • Optometrist
  • Nags Head, NC
  • NPI 1508309188

  Single Specialty

  Medicare reassignment NPD Authorized official
• Rappahannock Optical Inc

  • Durable Medical Equipment & Medical Supplies
  • Fredericksburg, VA
  • NPI 1568432763
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1528062015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 328",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279590328",
            "telephone_number": "252-489-5829",
            "fax_number": "252-376-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 WEST WOODHILL DRIVE",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279592795",
            "telephone_number": "252-261-8778",
            "fax_number": "252-715-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "AMOS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "01010249",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2015-00049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006352278",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harvard John Vanbelois, DDS
• Vann-Virginia Center for Orthopaedics PC
• John Robert Wallace, MSPT
• James S. Wilkinson, M. D.
• Amanda Joyner Williams, NP-C
• Christopher Winstead-Derlega, M.D. MPH
• Natalie B Woodard, PA-C
• Rebecca Anne Woods, LCSWA
• James Corbitt Woodson, D.D.S.
• Mark Stuart Worthen, MD

• Ophthalmology Physician in Nags Head, NC
• Providers in Nags Head, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.