Donald Willis, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A-822-85 Issued in NM

Practice address

313 W Country Club Rd
Suite # 9
Roswell, NM 88201-5804

Phone

(505) 624-1333

Fax

(505) 234-1362

NPI assigned

Apr 25, 2006

Last updated

Jul 8, 2007By 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Donald J Willis D.O. P.C.

  • Family Medicine Physician
  • Roswell, NM
  • NPI 1093955189
  Authorized official Same address or phone
• Pecos Valley of New Mexico, LLC

  • General Practice Physician
  • Carlsbad, NM
  • NPI 1972569820
  NPD (past)
• Covenant Medical Group

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1376598904
  NPD (past)
• Covenant Medical Group

  dba Covenant Family Healthcare Center

  • Rural Health Clinic/Center
  • Abernathy, TX
  • NPI 1538412895

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750347076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 N GUADALUPE ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882204676",
            "telephone_number": "505-887-8887",
            "fax_number": "505-234-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W COUNTRY CLUB RD",
            "address_2": "SUITE # 9",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015804",
            "telephone_number": "505-624-1333",
            "fax_number": "505-234-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "DONALD",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A-822-85",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40790",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dale Williams, LPCC
• Kila Williams, LCSW
• Mandisha Williams
• Teresa Diane Williams, LMSW,,LADAC
• Teri Williams
• Janice Susan Wilson, LISW
• Kirstyn Wilson
• Rachel Ann Wilson, PA-C
• Wendy Wilson
• Brandy Sue Withers

• Family Medicine Physician in Roswell, NM
• Providers in Roswell, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.