Lakisha Jeanette Burton Willis, MBA, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101273401 Issued in VA

Practice address

30 Town Center Way
Hampton, VA 23666-1999

Phone

(757) 251-2170

NPI assigned

Jun 25, 2015

Last updated

Sep 22, 2026By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1902288962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4188 OLD DOMINION DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232659",
            "telephone_number": "313-701-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 TOWN CENTER WAY",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661999",
            "telephone_number": "757-251-2170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 E Canfield St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482011928",
            "country_code": "US",
            "telephone_number": "313-577-1102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURTON WILLIS",
        "first_name": "LAKISHA",
        "middle_name": "JEANETTE",
        "name_prefix": "Mrs.",
        "credential": "MBA, M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301188560",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101273401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia E Burnette, LCSW
• Montecia Boyd Burno, FNP
• Maria Mercedes Burns, MSW
• Burt H Rubin (Peninsula Chiropracitc & or Prime Care Medical Group III)
• Kirsten Burt, LMFT
• Deangelo Burton
• Shelby Rae Burton
• Juanita Renee Burtt, NURSE PRACTITIONER
• Matthew Butcher, LPC
• Keona Byrd, AGACNP-BC

• Internal Medicine Physician in Hampton, VA
• Providers in Hampton, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.