Individual provider Active NPI

Gina M Willis

  • Licensed Practical Nurse
  • Colonial Heights, VA
National Provider Identifier
1669378444
Registry record updated Oct 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
0002086158 Issued in VA
Practice address
27 Brandywine CT
Colonial Heights, VA 23834-2176
Phone
(804) 908-8082
NPI assigned
Oct 17, 2026
Last updated
Oct 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0002086158 VA Primary

Addresses

Primary practice location

27 Brandywine CT
Colonial Heights, VA 23834-2176

Mailing address

27 Brandywine CT
Colonial Heights, VA 23834-2176
Phone (804) 908-8082

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1792195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792195200000",
    "number": "1669378444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 BRANDYWINE CT",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342176",
            "telephone_number": "804-908-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 BRANDYWINE CT",
            "city": "COLONIAL HEIGHTS",
            "state": "VA",
            "postal_code": "238342176",
            "telephone_number": "804-908-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "GINA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-17",
        "last_updated": "2026-10-17",
        "certification_date": "2026-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002086158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonial Heights, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.