Active NPI
Jasmine T Willis
- Community Health Worker
- Covington, GA
National Provider Identifier
1972410918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 14619682
- Practice address
- 525 Creekview Blvd
Covington, GA 30016-3084 - Phone
- (224) 423-8892
- NPI assigned
- Aug 25, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 14619682 | IL | Primary |
Addresses
Primary practice location
525 Creekview Blvd
Covington, GA 30016-3084
Mailing address
537 Central Parkway Rd
Woodstock, IL 60098-2660
Phone (224) 423-8892
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1972410918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "537 CENTRAL PARKWAY RD",
"city": "WOODSTOCK",
"state": "IL",
"postal_code": "600982660",
"telephone_number": "224-423-8892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 CREEKVIEW BLVD",
"city": "COVINGTON",
"state": "GA",
"postal_code": "300163084",
"telephone_number": "224-423-8892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "JASMINE",
"middle_name": "T",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-25",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "IL",
"license": "14619682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.