Tanya S Willis

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0000001707 Issued in TN

Practice address

10815 Old Highway 64
Bolivar, TN 38008-3599

Phone

(731) 658-2510

NPI assigned

Oct 10, 2012

Last updated

Oct 10, 2012By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Hardeman County Schools

  • Local Education Agency (LEA)
  • Bolivar, TN
  • NPI 1902144892
  NPD (past)

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1831441146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11415 LAKE HARDEMAN RD",
            "city": "MIDDLETON",
            "state": "TN",
            "postal_code": "380524237",
            "telephone_number": "731-609-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 OLD HIGHWAY 64",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380083599",
            "telephone_number": "731-658-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "TANYA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "0000001707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darshanula Wilkes
• Bruce Wilks, LADAC
• Emylee Ann Williams, OTR/L
• Kayla Williams, APRN, DNP, PMHNP-BC
• Elizabeth Ashley Willis, PHARMD
• Joselyn Wilson, PSYCHOLOGY
• Mary Wilson
• Thomas Gregory Wilson, DDS
• Sherwin A Yaffe, M.D.
• Yn Pakkala M.D, P.C

• Speech-Language Pathologist in Bolivar, TN
• Providers in Bolivar, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.