Individual provider Active NPI

Volney L Willett III, M.D.

  • Family Medicine Physician
  • Dickinson, ND
National Provider Identifier
1912964966
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14301 Issued in ND
Practice address
30 7TH St W
Suite LL-50
Dickinson, ND 58601-4335
Phone
(701) 483-6974
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M-11545 ID
Family Medicine Physician 207Q00000X 14301 ND Primary

Addresses

Primary practice location

30 7TH St W
Suite LL-50
Dickinson, ND 58601-4335

Mailing address

30 7TH St W Ste LL-50
Dickinson, ND 58601-4335
Phone (701) 483-6974

Other practice location 1

2305 37th Ave SW
Minot, ND 58701-7669
Phone (701) 418-8000

Other practice location 2

400 Burdick Expy E
Minot, ND 58701-4768
Phone (701) 857-7817

Other identifiers 3

IdentifierTypeStateIssuer
20000542OtherIDPTAN
1912964966MedicaidID
1469152MedicaidND

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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

Enrollment IDStateProvider typePAC IDDetails
I20250915000748 ND Order and Referring Only - Family PracticePractitioner - Family Practice 9234157215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14301NDMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: vwillett@direct.meditouchehr.com

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1912964966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 7TH ST W STE LL-50",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014335",
            "telephone_number": "701-483-6974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 7TH ST W",
            "address_2": "SUITE LL-50",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014335",
            "telephone_number": "701-483-6974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2305 37th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587017669",
            "country_code": "US",
            "telephone_number": "701-418-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Burdick Expy E",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587014768",
            "country_code": "US",
            "telephone_number": "701-857-7817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLETT",
        "first_name": "VOLNEY",
        "middle_name": "L",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-11545",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "14301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "20000542",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912964966",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1469152",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

Verify at the official NPI Registry.