Amber D Willis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

40153 Issued in SC

Practice address

1114 N Main St
Summerville, SC 29483-7326

Phone

(843) 212-8070

Fax

(843) 212-8071

NPI assigned

Apr 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amber W Hallmark Former name

Medicare fee-for-service enrollment

Enrolled in SC

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

Family Practice

Education

Baylor College of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLeod Health Clarendon Hospital, Manning, SC, CCN 420109

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awillis25359@directmcleodehealth.org

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.

• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  Medicare reassignment Care Compare group NPD
• McLeod Health Clarendon

  • Certified Registered Nurse Anesthetist
  • Manning, SC
  • NPI 1508218793

  Emergency Medicine

  Medicare reassignment NPD
• McLeod Regional Medical Center of the Pee Dee, Inc

  • Chronic Care Clinical Nurse Specialist
  • Florence, SC
  • NPI 1427004738
  Medicare reassignment NPD
• McLeod Health Clarendon

  • Rural Health Clinic/Center
  • Timmonsville, SC
  • NPI 1003461773

  Family Medicine

  NPD
• McLeod Health Clarendon

  • Family Medicine Physician
  • Manning, SC
  • NPI 1497104525
  NPD
• McLeod Regional Medical Center of the Pee Dee, Inc

  • Community/Retail Pharmacy
  • Florence, SC
  • NPI 1871775841
  NPD
• McLeod Regional Medical Center of the Pee Dee, Inc.

  • Family Medicine Physician
  • Florence, SC
  • NPI 1205882461
  NPD
• Washington Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Washington, PA
  • NPI 1639133861
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLeod Health Clarendon

  • Rural Acute Care Hospital
  • Manning, SC
  • NPI 1205284411
  Care Compare affiliation

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1649443607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 N MAIN ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294837326",
            "telephone_number": "843-212-8070",
            "fax_number": "843-212-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "AMBER",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "ML002812",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "40153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "HALLMARK",
            "middle_name": "W",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lasheya Williams
• Lindsey Williams, COTA/L
• Patrice Denise Williams, RN, ADN
• Sharreka A Williams
• James Reed Williamson, D.M.D.
• Matthew Michael Willis, DMD
• Willturn PC
• Kathryn Diana Wilson-Horney, DPM
• Rachel L Wilson-Johnson
• Esther Spiegle Wilson, MD

• Family Medicine Physician in Summerville, SC
• Providers in Summerville, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.