NPIMap

Organization Active NPI

Willis Family Medical Center, P.C.

  • Family Medicine Physician
  • Hermitage, TN
National Provider Identifier
1558616532
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD0000030394 Issued in TN
Legal business name
WILLIS FAMILY MEDICAL CENTER, P.C.
Practice address
3441 Lebanon Pike Ste 101
Hermitage, TN 37076-2000
Phone
(615) 316-5662
Fax
(615) 316-5666
NPI assigned
Jul 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Authorized official

Name
Andrea Bell-Willis, MDNPI 1659366870
Title
Owner
Phone
(615) 316-5662

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD0000030394 TN Primary

Addresses

Primary practice location

3441 Lebanon Pike Ste 101
Hermitage, TN 37076-2000

Mailing address

3441 Lebanon Pike Ste 101
Hermitage, TN 37076-2000
Phone (615) 316-5662

National Provider Directory

National Provider Directory

Locations

3441 Lebanon Pike
Ste 101
Hermitage, TN 37076
Phone (615) 316-5662

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1558616532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3441 LEBANON PIKE STE 101",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762000",
            "telephone_number": "615-316-5662",
            "fax_number": "615-316-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3441 LEBANON PIKE STE 101",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762000",
            "telephone_number": "615-316-5662",
            "fax_number": "615-316-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIS FAMILY MEDICAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "BELL-WILLIS",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-316-5662",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000030394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.