Melvin James Willis, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

TN 0250 Issued in TN

Practice address

James H Quillen/VA Medical Center
Coner of Sidney & Lamont
Johnson City, TN 37684

Phone

(423) 926-1171

Fax

(423) 979-3574

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700828977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 DOVE DR",
            "city": "JONESBORO",
            "state": "TN",
            "postal_code": "376594780",
            "telephone_number": "423-926-1171",
            "fax_number": "423-979-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JAMES H QUILLEN/VA MEDICAL CENTER",
            "address_2": "CONER OF SIDNEY & LAMONT",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-926-1171",
            "fax_number": "423-979-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MELVIN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "TN 0250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Turney Williams, M.D.
• Clifford G Williamson, MD
• Courtney S Willis, FNP
• Donald Clinton Willis, M.D.
• Kayla Nicole Willis, MD
• Angela G Willocks, NP
• Willow & Arbor, PLLC
• Lindsey Wills
• Wilson Pharmacy Inc (Mountain States Pharmacy at Boones Creek)
• Wilson Pharmacy, Inc (Mountain States Pharmacy Home Infusion Therapy)

• Medical Physician Assistant in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.