Individual provider Active NPI

Silas Willoughby Jr., ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Selah, WA
National Provider Identifier
1649782814
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61272511 Issued in WA
Practice address
609 Speyers Rd
Selah, WA 98942-1050
Phone
(509) 575-4084
NPI assigned
Oct 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61272511 WA Primary

Addresses

Primary practice location

609 Speyers Rd
Selah, WA 98942-1050

Mailing address

1724 Clio St
New Orleans, LA 70113-1210
Phone (504) 717-8224

Other practice location 1

1724 Clio St
New Orleans, LA 70113-1210
Phone (504) 717-8224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX, KY, WA4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20180208002998 LA Practitioner - Nurse Practitioner 9436327418 Reassigns benefits to 1 organization
I20190604001209 TX Practitioner - Nurse Practitioner 9436327418 Reassigns benefits to 1 organization
I20200114003546 KY Practitioner - Nurse Practitioner 9436327418 Reassigns benefits to 1 organization
I20240822003054 WA Practitioner - Nurse Practitioner 9436327418 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Current Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Apr 16, 2019 Accepting new patients
Ochsner Clinic LLC CurrentSince Feb 26, 2018 Accepting new patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Ochsner Clinic LLC CurrentSince Feb 26, 2018 Accepting new patients
Brock Medical, LLC CurrentSince Dec 1, 2019 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Dec 1, 2019 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Apr 16, 2019 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jul 16, 2024 Accepting new patients
Ridge Outpatient Counseling, LLC Psychiatric/Mental Health Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

301 Versailles Rd
Frankfort, KY 40601
Phone (502) 352-2310

1649 Highway 192 W
London, KY 40741
Phone (606) 330-0055

2215 Veterans Memorial Blvd
Metairie, LA 70002
Phone (504) 838-3524

1514 Jefferson Hwy
New Orleans, LA 70121

231 N Carrollton Ave
Ste B
New Orleans, LA 70119
Phone (504) 218-4853

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

Organizations & group practices 10

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": "1509148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1649782814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 CLIO ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701131210",
            "telephone_number": "504-717-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 SPEYERS RD",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989421050",
            "telephone_number": "509-575-4084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1724 Clio St",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701131210",
            "country_code": "US",
            "telephone_number": "504-717-8224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "SILAS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-28",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61272511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selah, WA

Sources for this page

Verify at the official NPI Registry.