Individual provider Active NPI

Patrick Willis, RRT

  • Critical Care Registered Respiratory Therapist
  • Los Angeles, CA
National Provider Identifier
1679826598
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Registered Respiratory TherapistTaxonomy code 2279C0205X
Practice address
11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Phone
(310) 478-3711
NPI assigned
Oct 16, 2012
Last updated
Oct 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Registered Respiratory Therapist 2279C0205X NU Primary
Emergency Care Registered Respiratory Therapist 2279E0002X NU
Geriatric Care Registered Respiratory Therapist 2279G0305X NU
General Care Registered Respiratory Therapist 2279G1100X 23048 CA
Neonatal/Pediatric Registered Respiratory Therapist 2279P3900X NU

Addresses

Primary practice location

11301 Wilshire Blvd
Los Angeles, CA 90073-1003

Mailing address

11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Phone (310) 478-3711

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

LicenseStateTypeSpecialty
23048CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1679826598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "310-478-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900731003",
            "telephone_number": "310-478-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "RRT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279C0205X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Critical Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2279E0002X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2279G0305X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Geriatric Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2279G1100X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, General Care",
            "state": "CA",
            "license": "23048",
            "primary": false
        },
        {
            "code": "2279P3900X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Neonatal/Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.