Active NPI
Hailey Renee Willard, DPT
- Physical Therapist
- League City, TX
National Provider Identifier
1730807827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1366336
- Practice address
- 1241 Butler Rd
League City, TX 77573-4873 - Phone
- (281) 938-1491
- NPI assigned
- Aug 16, 2022
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1366336 | TX | Primary |
Addresses
Primary practice location
1241 Butler Rd
League City, TX 77573-4873
Mailing address
1241 Butler Rd
League City, TX 77573-4873
Phone (281) 938-1491
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221012002076 | TX | Practitioner - Physical Therapist in Private Practice | 5991171266 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1366336 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1730807827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1241 BUTLER RD",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775734873",
"telephone_number": "281-938-1491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1241 BUTLER RD",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775734873",
"telephone_number": "281-938-1491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLARD",
"first_name": "HAILEY",
"middle_name": "RENEE",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-16",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1366336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in League City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.