Individual provider Active NPI

Ellen M Willard, MD

  • Hematology & Oncology Physician
  • Pinehurst, NC
National Provider Identifier
1669417820
Registry record updated Jan 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
34205 Issued in NC
Practice address
220 Page Rd
Pinehurst, NC 28374
Phone
(910) 715-3500
Fax
(910) 715-3501
NPI assigned
Jun 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 34205 NC Primary

Addresses

Primary practice location

220 Page Rd
Pinehurst, NC 28374

Mailing address

205 Page Rd
Pinehurst, NC 28374-8798
Phone (910) 295-5511

Other practice location 1

220 Page Rd
Pinehurst, NC 28374
Phone (910) 715-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20051121000870 NC Practitioner - Hematology/Oncology 1951320753 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Medical Clinic, Inc. CurrentSince Aug 19, 1991 Accepting new patients
Firsthealth of the Carolinas, Inc CurrentSince Oct 10, 2011 Accepting new patients
Pinehurst Medical Clinic, Inc. Hematology & Oncology CurrentSince Aug 19, 1991 Accepting new patients
Firsthealth of the Carolinas, Inc. Current Accepting new patients
Firsthealth of the Carolinas, Inc Dba Firsthealth Weight Management Clinic CurrentSince Feb 5, 2007 Accepting new patients
Firsthealth of the Carolinas, Inc. CurrentSince Feb 5, 2007 Accepting new patients
Pinehurst Medical Clinic, Inc. Past Accepting new patients

Locations

205 Page Rd
Pinehurst, NC 28374
Phone (910) 295-9211

8 Regional Cir
Pinehurst, NC 28374
Phone (910) 215-5555

220 Page Rd
Pinehurst, NC 28374
Phone (910) 715-3500

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

251 Campground Rd
West End, NC 27376
Phone (910) 715-6000

Interoperability endpoints

  • Direct secure messaging: ewillard13291@firsthealth.direct-ci.net

Organizations & group practices 7

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1669417820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PAGE RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748798",
            "telephone_number": "910-295-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 PAGE RD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-715-3500",
            "fax_number": "910-715-3501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Page Rd",
            "address_purpose": "LOCATION",
            "city": "Pinehurst",
            "state": "NC",
            "postal_code": "28374",
            "country_code": "US",
            "telephone_number": "910-715-3500",
            "fax_number": "910-715-3501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "ELLEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "34205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.