Active NPI
Joyce Willis
- Speech-Language Pathologist
- Englewood, OH
National Provider Identifier
1669827713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2615
- Practice address
- 153 Candle CT
Englewood, OH 45322-2741 - Phone
- (937) 430-0739
- NPI assigned
- Apr 26, 2016
- Last updated
- Apr 26, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2615 | OH | Primary |
Addresses
Primary practice location
153 Candle CT
Englewood, OH 45322-2741
Mailing address
153 Candle CT
Englewood, OH 45322-2741
Phone (937) 430-0739
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SP.2615 | Other | OH | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2615 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461628800000",
"number": "1669827713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 CANDLE CT",
"city": "ENGLEWOOD",
"state": "OH",
"postal_code": "453222741",
"telephone_number": "937-430-0739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 CANDLE CT",
"city": "ENGLEWOOD",
"state": "OH",
"postal_code": "453222741",
"telephone_number": "937-430-0739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "JOYCE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-26",
"last_updated": "2016-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "2615",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "SP.2615",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Englewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.