Individual provider Active NPI

Emily A Willard, DPT

  • Physical Therapist
  • Victor, NY
National Provider Identifier
1871848887
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305207493 Issued in VA
Practice address
590 Fishers Station Dr Ste 130
Victor, NY 14564-9744
Phone
(585) 924-7207
NPI assigned
Jul 16, 2012
Last updated
Apr 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305207493 VA Primary

Addresses

Primary practice location

590 Fishers Station Dr Ste 130
Victor, NY 14564-9744

Mailing address

803 Ridge Rd Ste a
Webster, NY 14580-2489
Phone (585) 347-0202

Other practice location 1

803 Ridge Rd Ste A
Webster, NY 14580-2489
Phone (585) 347-0202

Other identifiers 2

IdentifierTypeStateIssuer
1871848887OtherNYLICENSE
2305207493OtherVALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Leroy Physical Therapy and Athletic Training, PLLC Physical Therapist CurrentSince Aug 12, 2022 Accepting new patients
Premier Physical Therapy Physical Therapist CurrentSince Apr 1, 2007 Accepting new patients
Western New York Speech-Language Pathology, OT, and PT Consultants Past Accepting new patients
Mary Washington Hospital Inc. PastSince Sep 1, 2012 Accepting new patients

Locations

803 Ridge Rd
Ste A
Webster, NY 14580
Phone (585) 347-0202

6330 Five Mile Centre Park
Ste 406
Fredericksburg, VA 22407
Phone (540) 785-9770

7951 Kings Hwy
King George, VA 22485
Phone (540) 625-2300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1871848887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 RIDGE RD STE A",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145802489",
            "telephone_number": "585-347-0202",
            "fax_number": "585-347-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 FISHERS STATION DR STE 130",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649744",
            "telephone_number": "585-924-7207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "803 Ridge Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "NY",
            "postal_code": "145802489",
            "country_code": "US",
            "telephone_number": "585-347-0202",
            "fax_number": "585-347-0203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "EMILY",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1871848887",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2305207493",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.