DR. KENT AVERY WILLIS


Address: 853 Jefferson Ave Rm 201, Memphis, TN 38103-2807
Phone: 9012875265

DR. KENT AVERY WILLIS (NPI# 1528300431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528300431
Entity Type Individual
Full Name DR. KENT AVERY WILLIS
Credential MD
Practice Address 853 Jefferson Ave Rm 201
Memphis
TN 38103-2807
Practice Telephone 9012875265
Practice Fax Number 9014481691
Mailing Telephone 9012875265
Mailing Fax Number 9014481691
Enumeration Date 2013-03-19
Last Update Date 2019-10-22
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080N0001X Pediatrics
Specialization: Neonatal-Perinatal Medicine
54806 TN Allopathic & Osteopathic Physicians
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Other Providers KENT WILLIS

NPI Name Taxonomy Address Enumeration
1114306131 Kent Willis Family Medicine 830 N 2000 W, Pleasant Grove, UT 84062 2015-05-22

Office Location

Street Address 853 JEFFERSON AVE RM 201
City MEMPHIS
State TN
Zip Code 38103-2807

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619505724 Michelle Lynn Esposito Dietitian, Registered 1st Floor Research Center - 50 North Dunlap St, Memphis, TN 38103 2020-04-01
1962030221 Allison Burge Clayton Dietitian, Registered 50 N Dunlap, Nutrition Therapy Dept, 1st Floor Research Tower, Memphis, TN 38103 2020-03-31
1093375420 Radar Ems, LLC Social Worker 50 S. B.b. King Blvd, Suite 350, Memphis, TN 38103 2019-06-18
1528529021 Denise Andrews Matthews Nursing Care 342 Island Dr #105, Memphis, TN 38103 2019-03-27
1881160059 Christopher Paul Hernandez Nurse Practitioner 877 Jeffeon Ave, Memphis, TN 38103 2018-10-15
1194245712 Cameron Waters Clinard Optometrist 127 Isle Creek Dr, Memphis, TN 38103 2017-06-24
1750732582 Amanda Leigh Eaves Nurse Practitioner 364 S Front St Ste 201, Memphis, TN 38103 2016-06-22
1417304569 John Clark Shell Family Medicine 150 Harbor Creek Dr, Memphis, TN 38103 2016-05-18
1750753695 Tomisha V. Byard Nurse Practitioner 718 Habor Bend Road, Memphis, TN 38103 2015-10-29
1053795179 Melissa Anne Wilkes Social Worker 1240 Harbor River Drive, Memphis, TN 38103 2015-07-18
Find all providers in zip 38103

Taxonomy Information

Taxonomy Code 2080N0001X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Neonatal-Perinatal Medicine

Taxonomy Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1801367537 Stacie Nicole Yocom Pediatrics 853 Jefferson Ave Route E206, Memphis, TN 38163 2018-12-06
1518470780 Ashley Poynor Pediatrics 853 Jefferson Ave # Route206, Memphis, TN 38103-2807 2017-11-09
1659638310 Jennifer Michelle Davidson Pediatrics 853 Jefferson Ave Ste 201, Memphis, TN 38103 2012-04-19
1003137571 Mimily Harsono Pediatrics University of Tennessee (division of Neonatology), 853 Jefferson Avenue, Suite-201, Newborn Center, Memphis, TN 38103 2010-06-18
1487835229 Sandeep K. Chilakala Pediatrics 853 Jefferson Avenue, Suite 201, Memphis, TN 38103 2007-11-20
1346463130 Mohamad Tammam Elabiad Pediatrics Ut College of Medicine, 920 Madison Avenue Suite C50, Memphis, TN 38163-0001 2007-04-10
1992732580 Ramesh Krishnan Pediatrics 853 Jefferson Ave Ste 200, Memphis, TN 38103-2807 2006-06-27
1447217922 Ajay Talati Pediatrics 1910 Nonconnah Blvd Ste 120, Memphis, TN 38132-2113 2006-04-27
1548803919 Anna Kathryn Noel Pediatrics 1407 Union Ave Ste 700, Memphis, TN 38104-3641 2019-10-18
1780085787 Isaac John M.d., P.c Pediatrics 6005 Park Ave, Memphis, TN 38119-5202 2014-09-09
Find all providers in MEMPHIS

Competitor

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City MEMPHIS
Zip Code 38103

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Dataset Information

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.

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