DR. KIMBERLY RACHELLE WILLIS (NPI# 1487852562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487852562 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY RACHELLE WILLIS |
| Credential | MD |
| Practice Address |
2609 Medical Office Pl Goldsboro NC 27534-9428 |
| Mailing Address |
152 Aviary Ct Clayton NC 27520-4054 |
| Practice Telephone | 9197311779 |
| Mailing Telephone | 5017338722 |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2016-11-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2009-01271 | NC | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 2009-01271 | NC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649756826 | Kimberly Willis | Technician | 714 Jefferson Street, Bancroft, WV 25011 | 2018-07-11 |
| 1992201115 | Kimberly Nichelle Willis | Rehabilitation Practitioner | 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 | 2018-04-05 |
| 1629581251 | Kimberly A Willis | Counselor | 101 Dehler Dr, Sartell, MN 56377-4407 | 2017-11-06 |
| 1104279785 | Kimberly Renee Willis | Counselor | 9401 Southwest Fwy, Houston, TX 77074-1407 | 2016-07-19 |
| 1275925794 | Kimberly Willis | Nurse Practitioner | 700 W Market St, Athens, AL 35611-2457 | 2015-02-19 |
| 1568898393 | Kimberly Yvette Willis | Social Worker | 9401 Southwest Fwy, Houston, TX 77074-1407 | 2013-09-25 |
| 1255692729 | Kimberly Willis | Home Health Aide | 2004 Rhode Island Ave Ne, Suite 400, Washington, DC 20018 | 2012-05-31 |
| 1275869125 | Kimberly Deborah Willis | Adult Companion | 3111 Electric Ave, Port Huron, MI 48060-8127 | 2009-10-28 |
| 1164601514 | Kimberly Y Willis | Nurse Practitioner | 51 Performance Dr, Weymouth, MA 02189-3104 | 2007-11-01 |
| 1992990923 | Kimberly Renee Willis | Physical Therapist | 711 Avignon Dr, Ridgeland, MS 39157-5120 | 2007-09-12 |
| Street Address |
2609 MEDICAL OFFICE PL |
| City | GOLDSBORO |
| State | NC |
| Zip Code | 27534-9428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649253360 | Tara M Staton | Family Medicine | 2609 Medical Office Pl, Goldsboro, NC 27534-9428 | 2005-11-28 |
| 1982112066 | Tasha Westbrook Bollin | Nurse Practitioner | 2609 Medical Office Pl, Goldsboro, NC 27534-9428 | 2018-01-11 |
| 1033590401 | Lauren Lancaster | Nurse Practitioner | 2609 Medical Office Pl, Goldsboro, NC 27534-9428 | 2015-06-11 |
| 1205271145 | Aminu Isyaku Mohammed | Family Medicine | 2609 Medical Office Pl, Goldsboro, NC 27534-9428 | 2013-05-06 |
| 1679879522 | John Paul Kumhyr | Physician Assistant | 2609 Medical Office Pl, Goldsboro, NC 27534-9428 | 2011-02-09 |
| 1942513130 | Cassandra Marie Hopkins | Nurse Practitioner | 2609 Medical Office Pl, Goldsboro, NC 27534-9428 | 2010-07-16 |
| 1891011136 | Wake Heart and Vascular Associates Pa | Specialist | 2609 Medical Office Pl, Goldsboro, NC 27534-9428 | 2010-04-12 |
| 1861728792 | Eastern Medical Associates | Non-Pharmacy Dispensing Site | 2609 Medical Office Pl, Goldsboro, NC 27534-9428 | 2009-10-28 |
| 1164654893 | Shannon Ivy Speece | Nurse Practitioner | 2609 Medical Office Pl, Goldsboro, NC 27534-9428 | 2009-08-13 |
| 1437356565 | Veeresh Anand Medlery | Family Medicine | 2609 Medical Office Pl, Goldsboro, NC 27534-9428 | 2007-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457875767 | Trent Jonathan Forshey | Physical Therapist | 2126 Wayne Memorial Dr, Goldsboro, NC 27534 | 2017-07-28 |
| 1336685551 | Wayne Al Holdings, LLC | Assisted Living Facility | 901 West New Hope Rd, Goldsboro, NC 27534 | 2017-01-11 |
| 1952845471 | Latoya Faulk | Social Worker | 121 Carolina Forest Drive, Goldsboro, NC 27534 | 2016-12-19 |
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1528490604 | Eric Christian Bourgeois | Physical Therapist | 1101a Gracie Pl, Goldsboro, NC 27534 | 2013-07-31 |
| 1831439165 | Erica Nicole Davis | Optometrist | 20/20 Vision Center 625 North Berkeley Blvd, Suite D, Goldsboro, NC 27534 | 2013-02-23 |
| 1891039236 | Betty Webb Zimmerman | Nurse Practitioner | 204 Cox Blvd, Goldsboro, NC 27534 | 2012-11-26 |
| 1144595265 | Life Recovery Psychological Services | Counselor | 1202-c Wayne Memorial Dr, Goldsboro, NC 27534 | 2012-03-22 |
| 1558596536 | Taylor Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 802 Taylor St, Goldsboro, NC 27534 | 2009-05-20 |
| 1780895136 | Sherrie Fennell Edwards | Dietitian, Registered | 1500 Lanely Ave., Seymour Johnson Afb, Golsboro, NC 27534 | 2007-05-25 |
| Find all providers in zip 27534 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164769709 | Rosewood Medical | Family Medicine | 172 Nc Highway 581 S, Goldsboro, NC 27530-9404 | 2013-01-15 |
| 1952670838 | Rosewood Immediate Care | Family Medicine | 172 Us Highway 581 South, Goldsboro, NC 27530-9404 | 2011-12-21 |
| 1467619817 | Little River Med 1 Pa | Family Medicine | 210 N Herman St, Goldsboro, NC 27530-3810 | 2008-05-21 |
| 1588840417 | Felicia D. Hussey, M.d., P.a. | Family Medicine | 327 N Spence Ave, Goldsboro, NC 27534-4347 | 2008-01-10 |
| 1407908148 | Felicia D Hussey | Family Medicine | 327 North Spence Avenue, Goldsboro, NC 27534-4347 | 2007-01-16 |
| 1184706830 | Ellen Brubeck Brogden | Family Medicine | 1509 E Ash St, Goldsboro, NC 27530 | 2006-10-20 |
| 1225118839 | John Scott Mcconnaughey | Family Medicine | 400 Old Smithfield Rd, Goldsboro, NC 27530-8464 | 2006-10-17 |
| 1568552628 | Shannon R. Jimenez | Family Medicine | 2600 Us Highway 70 West, Goldsboro, NC 27530 | 2006-10-12 |
| 1871681478 | Anthony Clark Gaither | Family Medicine | 2607 Medical Office Pl, Goldsboro, NC 27534-9437 | 2006-10-10 |
| 1578662144 | Robert S. Meyer | Family Medicine | 208 N Herman St, Goldsboro, NC 27530-3810 | 2006-09-21 |
| Find all providers in GOLDSBORO | ||||
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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.