Active NPI
Alyssa May Willard, PA-C
- Physician Assistant
- Winston Salem, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-14887
- 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
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 |
|---|---|---|---|---|
| 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, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-14887 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group, Inc | Physician Assistant | Current | Accepting new patients |
| Medcare Express - North Charleston LLC | Current | 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
- 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.
-
- Family Medicine Physician
- Winston Salem, NC
- NPI 1427683044
-
- Urgent Care Clinic/Center
- Anderson, SC
- NPI 1841026382
-
- Urgent Care Clinic/Center
- Charleston, SC
- NPI 1457579617
-
- Surgery Physician
- Wethersfield, CT
- NPI 1043561301
Physician Assistant
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.