David Randall Willis, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO288 Issued in AL

Practice address

203 Tallapoosa Street
Wadley, AL 36276

Phone

(256) 395-4757

Fax

(256) 395-6055

NPI assigned

Jul 27, 2006

Last updated

Oct 12, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Family Practice

Education

Nova Southeastern College of Osteo Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Center Plus LLCGroup PAC ID 7911317755, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1605/brand/1/csg/26/fhir/r4

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.

• Medical Center Plus LLC

  • General Practice Physician
  • Auburn, AL
  • NPI 1104459411
  Medicare reassignment Care Compare group NPD
• American Family Care, LLC

  • Primary Care Clinic/Center
  • Birmingham, AL
  • NPI 1669429080
  Medicare reassignment NPD
• American Family Care, LLC

  • Family Medicine Physician
  • Vestavia Hills, AL
  • NPI 1265210645
  NPD
• American Family Care, LLC

  • Primary Care Clinic/Center
  • Wetumpka, AL
  • NPI 1568874543
  NPD
• Randolph Health Systems, LLC

  • General Acute Care Hospital
  • Roanoke, AL
  • NPI 1194892257
  NPD (past)
• Rmcca Clinic B, LLC

  dba Regional Medical Center Providers

  • Hospitalist Physician
  • Greenville, AL
  • NPI 1275184848

  Family Medicine

  NPD (past)
• Stabler Clinic, P.C.

  • Pediatrics Physician
  • Greenville, AL
  • NPI 1730181819

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1710901970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359020097",
            "telephone_number": "256-492-0131",
            "fax_number": "256-494-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 TALLAPOOSA STREET",
            "city": "WADLEY",
            "state": "AL",
            "postal_code": "36276",
            "telephone_number": "256-395-4757",
            "fax_number": "256-395-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "DAVID",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009995350",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110498",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Merritt, FNP
• Quality of Life Health Services, Inc (Wadley Cornerstone Clinic)
• Vernesa Sanford
• The Health Care Authority of the Town of Wedowee (Wedowee Hospital)
• Wedowee Hospital (Wadley Cornerstone Family Care)

• Family Medicine Physician in Wadley, AL
• Providers in Wadley, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.