Kody Allen Willis, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

841112 Issued in TX

Practice address

5412 24TH St
Lubbock, TX 79407-2130

Phone

(432) 935-1359

NPI assigned

Feb 20, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1740780212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5412 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072130",
            "telephone_number": "432-935-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KODY",
        "middle_name": "ALLEN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "841112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trashanda Jean Williams, LPC-ASSOCIATE
• Williamsburg Orthotic and Prosthetic Inc
• Sara Ann Williamson, LPC
• Katelyn Rebecca Willingham, OTR
• Alyssa Kathryn Willis, LPC
• David Blair Willson
• April Tulane Wilmeth, OTR
• Ashley Butchee Wilmeth, MS, RD, LD
• Christy Wilmeth, LPC
• Henrik Wilms, MD

• Registered Nurse in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; 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.