William Wyatt Willis, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1592 Issued in WV

Practice address

126 Trivette Dr
Suite 102
Pikeville, KY 41501-1275

Phone

(606) 432-2202

Fax

(606) 432-2429

NPI assigned

Jul 17, 2006

Sex

Male

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 1

Other names 1

• William Wyatt Willis Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: wwwillis@yourcarecommunity.org

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1972520567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 TRIVETTE DR",
            "address_2": "SUITE 102",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011275",
            "telephone_number": "606-432-2202",
            "fax_number": "606-432-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 TRIVETTE DR",
            "address_2": "SUITE 102",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011275",
            "telephone_number": "606-432-2202",
            "fax_number": "606-432-2429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "WILLIAM",
        "middle_name": "WYATT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "02719",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6403711200",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "WILLIS",
            "middle_name": "WYATT",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Linda E. Williams, N.P.
• Loren N Williams, DMD
• Maranda Lashea Williams, RBT
• Marc Williams, DMD
• Wesley Dylan Williams, RBT
• Wilson & Wheeler PSC
• Sarah N. Wilson, PA-C
• Amanda Woods, TCM
• Megan Worley
• Courtney Nicole Wright, PHARMD

• Family Medicine Physician in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.