Phyllis Ann Willis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

108842 Issued in MO

Practice address

404 N Keene St
Columbia, MO 65201-6626

Phone

(573) 875-9224

Fax

(573) 875-9284

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• Anesthesia Associates of Oklahoma PLLC

  • Anesthesiology Physician
  • Tulsa, OK
  • NPI 1770891475
  NPD (past)
• Anesthesiology Management Inc

  • Anesthesiology Physician
  • Enid, OK
  • NPI 1679521355
  NPD (past)
• Clinton Hma, LLC

  dba AllianceHealth Clinton

  • General Acute Care Hospital
  • Clinton, OK
  • NPI 1326062456
  NPD (past)
• Gilbert M Rogers DO PC

  • Certified Registered Nurse Anesthetist
  • Enid, OK
  • NPI 1154548493

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)
• St Marys Anesthesia Group

  • Anesthesiology Physician
  • Enid, OK
  • NPI 1629010269
  NPD (past)
• Uhs of Oklahoma Inc

  dba St Mary's Regional Medical Center

  • Diagnostic Radiology Physician
  • Enid, OK
  • NPI 1982795696
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1912916677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016626",
            "telephone_number": "573-875-9224",
            "fax_number": "573-875-9284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "PHYLLIS",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "R0032281",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "108842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00400212",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "914449004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Todd Williamson, PHD
• Hope Madison Williard, PA-C
• Zachary Williard
• Dale Willis, M.A.
• Lia Willis, PH.D.
• Willowtree Isl (Lorrie R. Ney)
• Theodore E Wills, MD
• Thomas David Willson, MD
• Gilbert Wilshire, M.D.
• Anna Wilson

• Certified Registered Nurse Anesthetist in Columbia, MO
• Providers in Columbia, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.