Sherita D Willis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E5031 Issued in AR

Practice address

616 W Lee Ave
Osceola, AR 72370-3002

Phone

(870) 702-0999

NPI assigned

Jan 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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 PracticeAlso: Emergency Medicine

Education

University of Arkansas College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Great River Medical Center Hospital, Blytheville, AR, CCN 040069
• South Mississippi County Regional Medical Center Hospital, Osceola, AR, CCN 040782
• St Bernards Medical Center Hospital, Jonesboro, AR, CCN 040020

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdwillis@yourcarecommunity.org
• Direct secure messaging: sherita.willis.1@15827.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/15827/brand/1/csg/1/fhir/r4

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

• East Arkansas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Blytheville, AR
  • NPI 1932442985
  Medicare reassignment NPD
• Willis Clinic

  • Primary Care Clinic/Center
  • Osceola, AR
  • NPI 1063619567
  Medicare reassignment NPD
• RH Arkansas Emergency Medicine, PLLC

  • Emergency Medicine Physician
  • Blytheville, AR
  • NPI 1801643499
  Medicare reassignment
• East Arkansas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Clarksville, AR
  • NPI 1609259753
  NPD
• Northeast Arkansas Clinic, PA

  • Multi-Specialty Clinic/Center
  • Jonesboro, AR
  • NPI 1376517177
  NPD (past)
• Tyler Emergency Physicians

  • Emergency Medicine Physician
  • West Memphis, AR
  • NPI 1669416384
  NPD (past)

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

• Mississippi County Hospital System

  • General Acute Care Hospital
  • Blytheville, AR
  • NPI 1316180748
  Care Compare affiliation
• SMC-Mississippi County Hospital System

  • Rural Acute Care Hospital
  • Osceola, AR
  • NPI 1366685992
  Care Compare affiliation
• St Bernards Hospital Inc

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1922043686
  Care Compare affiliation

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1740326610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 W LEE AVE",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723703002",
            "telephone_number": "870-702-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 W LEE AVE",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723703002",
            "telephone_number": "870-702-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "SHERITA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "40746",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E5031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica L. Wilburn
• Libby Wilhite, RN
• Charles Williams Jr., MTTPP
• Willis Clinic
• Willis Clinic Express
• Anna Walker Willoughby, LAC
• Mark K Wilson, DDS
• Millie Diane Wimberley
• Linda Childers Wright
• Patricia Dolly Wroten, MHPP

• Family Medicine Physician in Osceola, AR
• Providers in Osceola, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; 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.