NPIMap

Individual provider Active NPI

Kevin J Willis, M.D.

  • Family Medicine Physician
  • Ashland, KY
National Provider Identifier
1700919776
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25530 Issued in KY
Practice address
2201 Lexington Ave
Ashland, KY 41101-2843
Phone
(606) 408-4000
Fax
(606) 408-7426
NPI assigned
Mar 13, 2007
Last updated
Apr 7, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25530 KY Primary
Family Medicine Physician 207Q00000X 35.053911 OH
Hospitalist Physician 208M00000X 25530 KY

Addresses

Primary practice location

2201 Lexington Ave
Ashland, KY 41101-2843

Mailing address

P.O. Box 2379
Ashland, KY 41105-2379
Phone (606) 408-6200

Other identifiers 4

IdentifierTypeStateIssuer
000000161894OtherKYANTHEM
64255300MedicaidKY
3810010701MedicaidWV
0628922MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050901000033 KY Practitioner - HospitalistPractitioner - Family Practice 2567494370 Reassigns benefits to 1 organization
I20150416000498 OH Practitioner - HospitalistPractitioner - Family Practice 2567494370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
JC Edwards School of Medicine, Marshall University, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2201 Lexington Ave
Ashland, KY 41101-2843
Phone (606) 408-4000

398 Diederich Blvd
Ashland, KY 41101-7008
Phone (606) 324-2055

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.04 of 100Reported as group
Quality
60.55
Promoting interoperability
100
Improvement activities
40
Cost
78.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25530KYMDFamily Medicine Physician
35.053911OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Aug 1, 2012 Accepting new patients
Kings Daughters Medical Specialties Inc Family Medicine CurrentSince Mar 7, 2015 Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Aug 1, 2012 Accepting new patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
Community Hospice, Inc. Family Medicine Past Accepting new patients
Community Hospice Inc Family Medicine Past Accepting new patients
Ashland Hospital Corporation Family Medicine Past Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

1242 Crescent Dr
Wheelersburg, OH 45694
Phone (740) 574-8441

Interoperability endpoints

  • Direct secure messaging: kwillis9526@direct.kdhealth.us

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1700919776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 LEXINGTON AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012843",
            "telephone_number": "606-408-4000",
            "fax_number": "606-408-7426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "25530",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.053911",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "25530",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000161894",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64255300",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810010701",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0628922",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.