Phyllis Lynn Willis, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1074431 Issued in AL

Practice address

1901 Melba Dr
Dothan, AL 36301-3017

Phone

(334) 794-6611

Fax

(334) 794-6614

NPI assigned

Mar 31, 2008

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

Enrolled in AL, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: phyllis.willis.1@15989.direct.athenahealth.com

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.

• Tanana Chiefs Conference

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1821201278

  TX

  Medicare reassignment Care Compare group NPD
• App of Alabama Ed PLLC

  • Emergency Medicine Physician
  • Russellville, AL
  • NPI 1659646040
  Medicare reassignment NPD
• Northern Alabama Physicians, LLP

  • Emergency Medicine Physician
  • Decatur, AL
  • NPI 1669618310
  Medicare reassignment NPD
• Ronnie T Chu MD P C

  • Legal Medicine
  • Demopolis, AL
  • NPI 1447450465
  Medicare reassignment NPD
• Northern Alabama Physicians, LLP

  • Hospitalist Physician
  • Enterprise, AL
  • NPI 1952845711
  NPD
• Northern Alabama Physicians, LLP

  • Hospitalist Physician
  • Dothan, AL
  • NPI 1992178628
  NPD
• Tanana Chiefs Conference

  • Ambulatory Surgical Clinic/Center
  • Fairbanks, AK
  • NPI 1871332387
  NPD

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1922270958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MELBA DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013017",
            "telephone_number": "334-794-6611",
            "fax_number": "334-794-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MELBA DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013017",
            "telephone_number": "334-794-6611",
            "fax_number": "334-794-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "PHYLLIS",
        "middle_name": "LYNN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1074431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willingham Medical Clinic, RHC, PLLC
• Amber Willis
• Kasey Willis, PHARMD
• Kayla Willis, AUD
• Mark L Willis, MD
• Wilson Miller Counseling Services LLC
• Alyssa Jordan Wilson, CRNP
• Ayala Wilson
• James Olin Wilson Jr., RPH
• Philip Thomas Wilson, D.O.

• Family Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.