Michelle Rene Willis, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

53-78546-122 Issued in KS

Practice address

3901 E 32ND St
Joplin, MO 64804-3312

Phone

(417) 347-7600

NPI assigned

Jan 26, 2019

Sex

Female

Sole proprietor

No

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

Enrolled in MO

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 1

Specialty

Nurse Practitioner

Education

University of Missouri, Kansas City, School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ozark CenterGroup PAC ID 4789588088, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ozark Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Joplin, MO
  • NPI 1790796878
  Medicare reassignment Care Compare group NPD
• Ozark Center

  • Behavior Analyst
  • Joplin, MO
  • NPI 1790038511
  NPD

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

{
    "created_epoch": "1548460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548460800000",
    "number": "1770047557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 5TH ST",
            "city": "OSWEGO",
            "state": "KS",
            "postal_code": "673562101",
            "telephone_number": "620-423-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 E 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043312",
            "telephone_number": "417-347-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MICHELLE",
        "middle_name": "RENE",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-26",
        "last_updated": "2019-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "53-78546-122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miles J Williams
• Zachary E Williams
• Nancy M Willis-Smith, FNP-C, WHNP-BC
• Donovan Scott Willis, CRNA
• Michaela Willis
• Sarah Annette Willoughby, L.C.S.W.
• Alicia Wilson
• Brett Michael Wilson, D.D.S.
• Danielle Wilson
• Darrell A Wilson, LPC, CRC

• Psychiatric/Mental Health Nurse Practitioner in Joplin, MO
• Providers in Joplin, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2019; 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.