WAYNE S WILLIS MD LLC (NPI# 1528039021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528039021 |
| Entity Type | Organization |
| Organization Name | WAYNE S WILLIS MD LLC |
| Practice Address |
3111 Peggy Bond Dr Pensacola FL 32504-5018 |
| Practice Telephone | 8504389755 |
| Practice Fax Number | 8504380699 |
| Mailing Telephone | 8504389755 |
| Mailing Fax Number | 8504380699 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2013-02-05 |
| Authorized Official Name | WAYNE S. WILLIS (PRESIDENT) |
| Authorized Official Telephone | 8504389755 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 274727800 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | 98793 | 01 |
| Street Address |
3111 PEGGY BOND DR |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32504-5018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215349535 | Wayne S. Willis Md LLC | Clinic/Center | 3111 Peggy Bond Dr, Pensacola, FL 32504-5018 | 2014-05-21 |
| 1992735161 | Contact Lens & Eye Care of Pensacola Inc | Optometrist | 3111 Peggy Bond Dr, Pensacola, FL 32504-5018 | 2006-07-04 |
| 1003880667 | Wayne S Willis | Family Medicine | 3111 Peggy Bond Dr, Pensacola, FL 32504-5018 | 2006-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659978393 | Quinyatta Stride | Behavior Technician | 2511 Creighton Rd., Pensacola, FL 32504 | 2020-10-06 |
| 1962017657 | Pt Solutions of Pensacola LLC | Occupational Therapist | 2114 Creighton Rd, Ste C, Pensacola, FL 32504 | 2020-09-10 |
| 1982226742 | Elevate Behavioral Solutions | Behavioral Analyst | 4045 Renoir St, Pensacola, FL 32504 | 2020-05-14 |
| 1760021349 | Veteran Evaluations of Florida | Internal Medicine | 2411 Executive Plaza Drive, Suite A, Pensacola, FL 32504 | 2019-12-31 |
| 1215575527 | First City Health LLC | Pharmacy | 6005 College Parkway, Suite 1, Pensacola, FL 32504 | 2019-12-17 |
| 1184261158 | Claire Ann Letendre | Audiologist | 5153 N 9th Ave Pediatric Off Building, Pensacola, FL 32504 | 2019-12-09 |
| 1083275101 | Benjamin Mcmillon | Chiropractor | 2629 Creighton Road, Suite 1, Pensacola, FL 32504 | 2019-06-28 |
| 1407342595 | Faryal Munir | Student in an Organized Health Care Education/Training Program | Uf Pediatric Residency 5151 North 9th Ave, 6th Floor Nemours, Pensacola, FL 32504 | 2018-07-02 |
| 1497252050 | Sibyl Tenille Page | Nurse Practitioner | 5147 N 9th Ave Ste 322, Pensacola, FL 32504 | 2018-04-10 |
| 1396272589 | Sacred Heart Hospital | General Acute Care Hospital | 2552 Carmel Heights Rd, Pensacola, FL 32504 | 2017-05-18 |
| Find all providers in zip 32504 | ||||
| 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 |
|---|---|---|---|---|
| 1508473588 | Marathon Health LLC | Family Medicine | 2257 N Baylen St, Pensacola, FL 32501-1703 | 2020-09-24 |
| 1063049666 | Beth Sample | Family Medicine | 418 W Brainerd St, Pensacola, FL 32501-3062 | 2020-03-24 |
| 1326688458 | Jeane M Thomas | Family Medicine | 4734 Huron Dr, Pensacola, FL 32507-8737 | 2020-01-07 |
| 1932667391 | Julie Ahrend | Family Medicine | 2603 N 16th Ave, Pensacola, FL 32503-4635 | 2019-03-05 |
| 1942765292 | Access Care Family Medicine | Family Medicine | 6705 Pine Forest Rd Ste 505, Pensacola, FL 32526-6911 | 2019-01-31 |
| 1417441742 | Alisha Watson | Family Medicine | 1549 Airport Blvd Ste 200b, Pensacola, FL 32504-8634 | 2018-06-20 |
| 1477094753 | Emily Ellen Crocetti | Family Medicine | Family Medicine Department 6000 W Us Hwy 98, Pensacola, FL 32512-1200 | 2017-03-20 |
| 1821533001 | William Belk Md LLC | Family Medicine | 3450 Oakmont Dr, Pensacola, FL 32503-6900 | 2016-12-27 |
| 1851756852 | Michelle Lynn Smith | Family Medicine | 3700 Creighton Rd, Suite 4, Pensacola, FL 32504-4680 | 2015-12-18 |
| 1659777985 | Dolores Anne Holtmann | Family Medicine | 9400 University Pkwy Ste 409, Pensacola, FL 32514-5485 | 2014-11-13 |
| Find all providers in PENSACOLA | ||||
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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.