James Willis

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · City of Wilkes Barre, PA

NPI 1982186268 · NPPES record last updated Sep 3, 2018

Key facts

NPI
1982186268
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
133 N River St
City of Wilkes Barre, PA 18702-2404
Phone
(570) 208-5900
NPI assigned
Sep 3, 2018
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
King'S College Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
2255A2300X
Student in an Organized Health Care Education/Training Program
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
390200000X Yes

Addresses

Primary practice location

133 N River St
City of Wilkes Barre, PA 18702-2404

Mailing address

133 Pennwick Dr
Lititz, PA 17543-7628

Other providers in City of Wilkes Barre, PA

All providers in City of Wilkes Barre, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania

Sources for this page

Verify at the official NPI Registry.