Individual provider Active NPI

Alyssa L.M. Willis, CPNP-PC

  • Pediatric Nurse Practitioner
  • Canton, GA
National Provider Identifier
1568030112
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN224983 Issued in GA
Practice address
450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone
(770) 224-1000
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN224983 GA Primary

Addresses

Primary practice location

450 Northside Cherokee Blvd
Canton, GA 30115-8015

Mailing address

1654 Fair Oak Way
Mableton, GA 30126-5754
Phone (228) 238-1211

Other practice location 1

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN224983GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Steps Pediatrics, LLC PastSince Jun 15, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alyssalmccallwillis@healthystepspediatrics.opdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1568030112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1654 FAIR OAK WAY",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301265754",
            "telephone_number": "228-238-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NORTHSIDE CHEROKEE BLVD",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158015",
            "telephone_number": "770-224-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Northside Forsyth Dr",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417659",
            "country_code": "US",
            "telephone_number": "770-844-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ALYSSA",
        "middle_name": "L.M.",
        "credential": "CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN224983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.