John Kelver Willis, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

MD.04407R Issued in LA

Practice address

2810 E Causeway Approach
Mandeville, LA 70448-3502

Phone

(985) 875-2340

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Administrators of the Tulane Education Fund

  • Anatomic Pathology & Clinical Pathology Physician
  • New Orleans, LA
  • NPI 1790354595
  NPD (past)
• Administrators of the Tulane Educational Fund

  • Specialist
  • New Orleans, LA
  • NPI 1528014164
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1609894765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 E CAUSEWAY APPROACH",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483502",
            "telephone_number": "985-875-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JOHN",
        "middle_name": "KELVER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "LA",
            "license": "MD.04407R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1190951",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125480",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myreka Richelle Williams
• Ruston Lee Williams, D.C.
• Trudy Meyers Williams, RD, LDN
• Wilbert Lee Williams Jr.
• Rebecca Willingham, PMHNP
• April Wilson
• Louis Philip Wingerter, RPH
• Shelly Ann Witman, SLP
• Victoria Witt, PHD, MS
• Amy Elizabeth Wolke

• Neurology with Special Qualifications in Child Neurology Physician in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.