Crystal Lynn Willis, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

002045 Issued in GA

Practice address

775 Sunset Dr
Athens, GA 30606-2211

Phone

(706) 425-1543

NPI assigned

Nov 27, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1639413966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 LEM EDWARDS RD",
            "city": "WINTERVILLE",
            "state": "GA",
            "postal_code": "306832021",
            "telephone_number": "706-255-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 SUNSET DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062211",
            "telephone_number": "706-425-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "CRYSTAL",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "002045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael A Williams Sr., PC
• Nancy Williams, FNP-C
• Tanya Mueller Williams, OTA/L
• Timothy C Williams
• Phyllis Willingham, RN
• Gina Willis
• Patrick D Willis, MD
• Alvin T Wilson III, D.O.
• Andrew A Wilson, MD
• Barbara Wilson, MS

• Physical Therapy Assistant in Athens, GA
• Providers in Athens, GA by specialty
• Physical Therapy Assistant in Georgia

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