WILLIS CLINIC (NPI# 1063619567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063619567 |
| Entity Type | Organization |
| Organization Name | WILLIS CLINIC |
| Practice Address |
616 W Lee Ave Osceola AR 72370-3002 |
| Practice Telephone | 8705632545 |
| Practice Fax Number | 8705632482 |
| Mailing Telephone | 8705632545 |
| Mailing Fax Number | 8705632482 |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2019-10-11 |
| Authorized Official Name | MR. TIMOTHY W WILLIS (COO/PRACTICE MANAGER) |
| Authorized Official Telephone | 8705632545 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
E5031 | AR | Ambulatory Health Care Facilities |
| Street Address |
616 W LEE AVE |
| City | OSCEOLA |
| State | AR |
| Zip Code | 72370-3002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740326610 | Sherita D Willis | Family Medicine | 616 W Lee Ave, Osceola, AR 72370-3002 | 2007-01-29 |
| 1053811752 | Jiva Marie Pate | Family Medicine | 616 W Lee Ave, Osceola, AR 72370-3002 | 2018-02-19 |
| 1407388267 | Carolyn Coleman | Nurse Practitioner | 616 W Lee Ave, Osceola, AR 72370-3002 | 2017-03-31 |
| 1174959795 | Willis Clinic Express | Clinic/Center | 616 W Lee Ave, Ste 2a, Osceola, AR 72370-3002 | 2013-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417411570 | Southern Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 922 West Kizer St., Osceola, AR 72370 | 2019-01-23 |
| 1831431733 | Shaquata Davis | Social Worker | 1487 West Keiser Ave. Suite 1, Osceola, AR 72370 | 2013-03-19 |
| 1821348855 | Mary Kathryn Campbell | Speech-Language Pathologist | 315 E Union, Osceola, AR 72370 | 2012-09-18 |
| 1518230697 | Nikki D Moore | Case Manager/Care Coordinator | 1487 West Keiser Ave Ste I, Osceola, AR 72370 | 2012-02-20 |
| 1134497845 | Tim Allen | Case Manager/Care Coordinator | 3201 W. Keiser Ave., Osceola, AR 72370 | 2011-12-08 |
| 1184929663 | Gail Renee Barger | Counselor | 3201 West Keiser, Osceola, AR 72370 | 2011-01-14 |
| 1134423833 | Donna Susan Richmond | Speech-Language Pathologist | 1866 S Hwy 77, Osceola, AR 72370 | 2011-01-10 |
| 1972807592 | Meredith Annette Harris | Case Manager/Care Coordinator | 3201 West Keiser Ave, Osceola, AR 72370 | 2010-12-23 |
| 1093018871 | Tabatha G Bingham | Case Manager/Care Coordinator | 3201 W. Keiser, Osceola, AR 72370 | 2010-12-16 |
| 1588974109 | Sheila Lynette Rumph | Case Manager/Care Coordinator | 1487 W. Keiser Ave. Suite 1, Osceola, AR 72370 | 2010-10-15 |
| Find all providers in zip 72370 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972876969 | C. S. Lin Md | Clinic/Center | 608 W Lee Ave, Osceola, AR 72370-3002 | 2012-02-21 |
| 1710399159 | Compass Health | Clinic/Center | 530 Arduser Dr, Osceola, MO 64776-6284 | 2014-05-20 |
| 1134304603 | St. Clair County Hospital District No. 1 | Clinic/Center | 700 Giesler Rd, Osceola, MO 64776-6279 | 2008-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275134603 | Sheridan Family Clinic, Pllc | Clinic/Center | 109 W Pine St Ste A, Sheridan, AR 72150-2443 | 2020-11-03 |
| 1346848850 | Arkansas Premier Medical Clinic | Clinic/Center | 22461 I 30 Ste 402, Bryant, AR 72022-2383 | 2020-10-16 |
| 1659985570 | Premise Health of Arkansas Medical P A | Clinic/Center | 3307 N 2nd St, Rogers, AR 72756-0001 | 2020-09-08 |
| 1497376321 | Magnolia Regional Health System Inc | Clinic/Center | 1010 N Dudney Rd Ste C, Magnolia, AR 71753-2651 | 2020-05-01 |
| 1548892433 | Genesis Health and Wellness, Pllc | Clinic/Center | 110 N Hendrix St, Imboden, AR 72434-9077 | 2020-02-07 |
| 1700430386 | Kidspiration of Marion County | Clinic/Center | 81 Development Dr, Yellville, AR 72687-0662 | 2019-07-31 |
| 1891357455 | Pinnacle Health Partners Pllc | Clinic/Center | 17447 Highway 9, Benton, AR 72019-9223 | 2019-07-03 |
| 1083273007 | Diane K Bodemann Md Ltd | Clinic/Center | 256 Grandstaff Dr, Hot Springs, AR 71913-8789 | 2019-06-12 |
| 1265098552 | Community Family Medical LLC | Clinic/Center | 1139 North Highway 77, Marion, AR 72364-9027 | 2019-05-13 |
| 1174187132 | Arcare | Clinic/Center | 3800 Rogers Ave Ste 6, Fort Smith, AR 72903-3075 | 2019-04-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.