Brian M Wills, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4351 Issued in TN

Practice address

776 Weatherly Dr Ste B
Clarksville, TN 37043-8941

Phone

(615) 941-8501

Fax

(615) 941-8102

NPI assigned

May 5, 2011

Sex

Male

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 TN

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Advanced Diagnostic Imaging, PC

  • Internal Medicine Physician
  • Goodlettsville, TN
  • NPI 1093741464

  Physician Assistant

  Medicare reassignment NPD
• The Joint and Spine Pain Center

  • Pain Medicine Physician
  • Clarksville, TN
  • NPI 1154386282
  Medicare reassignment NPD
• Advanced Diagnostic Imaging PC

  • Durable Medical Equipment & Medical Supplies
  • Lewisburg, TN
  • NPI 1922846559
  NPD

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1962794172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-239-2018",
            "fax_number": "615-851-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 WEATHERLY DR STE B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438941",
            "telephone_number": "615-941-8501",
            "fax_number": "615-941-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "BRIAN",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-05",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T'Kai Y Williams, BEHAVIORAL TECHNICIA
• Veronique Williams
• Victoria Williams, LMSW, CSW
• Jamie Williamson
• Lynson Willis, ATC,CES,PES,DN2,SMTC
• Caroline Louise Wilson, FNP
• Cathryne Renee Wilson
• Elizabeth Ann Wilson, BS
• Haley McKenzie Duke Wilson
• Jacqueline Wilson, APRN

• Physician Assistant in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.