Individual provider Active NPI

Alyssa May Willard, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1770012601
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-14887 Issued in NC
Practice address
2085 Frontis Plaza Blvd
Winston Salem, NC 27103-5614
Phone
(704) 316-4136
NPI assigned
Jun 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-14887 NC Primary

Addresses

Primary practice location

2085 Frontis Plaza Blvd
Winston Salem, NC 27103-5614

Mailing address

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 972-6977

Other practice location 1

631 Johnnie Dodds Blvd
Mount Pleasant, SC 29464-3030
Phone (843) 881-0815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191216001733 SC Practitioner - Physician Assistant 7416220207 Reassigns benefits to 2 organizations
I20260409002917 NC Practitioner - Physician Assistant 7416220207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
NH Digital Health Services LLCGroup PAC ID 9537588934, 37 clinicians
Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

2085 Frontis Plaza Blvd
Winston Salem, NC 27103-5614
Phone (704) 316-4136

6167 Braided Mane Pass SW
Aiken, SC 29803-7839
Phone (803) 648-1464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-14887NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc Physician Assistant CurrentSince Jul 1, 2017 Accepting new patients
Medcare Express - North Charleston LLC CurrentSince Oct 23, 2019 Accepting new patients

Locations

385 W Main St
Avon, CT 06001
Phone (860) 777-1280

111 Salem Tpke
Ste 8
Norwich, CT 06360
Phone (860) 886-0023

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

8720 Dorchester Rd
North Charleston, SC 29420
Phone (843) 552-3629

Interoperability endpoints

  • Direct secure messaging: alyssa.willard@420883186974724.direct.elationemr.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1770012601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "860-972-6977",
            "fax_number": "860-972-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 FRONTIS PLAZA BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035614",
            "telephone_number": "704-316-4136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "631 Johnnie Dodds Blvd",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294643030",
            "country_code": "US",
            "telephone_number": "843-881-0815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "ALYSSA",
        "middle_name": "MAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.