KIMBERLY D WILLIS (NPI# 1558496448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558496448 |
| Entity Type | Individual |
| Full Name | KIMBERLY D WILLIS |
| Credential | ACNP RN |
| Practice Address |
166 Stoneridge Drive Columbia SC 29210 |
| Practice Telephone | 8034613000 |
| Practice Fax Number | 8034614903 |
| Mailing Telephone | 8034613000 |
| Mailing Fax Number | 8034614903 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2016-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 2015 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| 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 |
166 STONERIDGE DRIVE |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356322812 | Robert E Smith Jr. | Internal Medicine | 166 Stoneridge Drive, Columbia, SC 29210 | 2005-11-10 |
| 1346401965 | Ashley Noelle Miller | Nurse Practitioner | 166 Stoneridge Drive, South Carolina Oncology Associates, Pa, Columbia, SC 29045 | 2008-06-17 |
| 1447474978 | Mohamed Medhat El Geneidy | Internal Medicine | 166 Stoneridge Drive, Columbia, SC 29210-8239 | 2007-04-13 |
| 1477688356 | Jacqueline Imogene Conder | Nurse Practitioner | 166 Stoneridge Drive, Columbia, SC 29210 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700413838 | Alexis Koreema Brown | Social Worker | 3205 Montcrest Rd., Columbia, SC 29210 | 2020-03-26 |
| 1942767843 | Thomas Edwin Cromer | Social Worker | 409 Evelyn Drive, Columbia, SC 29210 | 2019-02-27 |
| 1184193542 | Helen Hoffman Coleman | Pharmacist | 16 Berryhill Road, Ste 109, Columbia, SC 29210 | 2018-11-15 |
| 1356828040 | Latia Kelly Mcdonald | Counselor | 105 Beth Hope Lane, Columbia, SC 29210 | 2018-07-25 |
| 1356892848 | Butterfly Effects LLC | Community/Behavioral Health | 1607 Bentley Court, Columbia, SC 29210 | 2016-10-19 |
| 1114373651 | Lilian Emetu | Nurse Practitioner | 822 Statler Road, Columbia, SC 29210 | 2016-05-13 |
| 1154776433 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 507 Piney Grove Rd, Columbia, SC 29210 | 2016-04-25 |
| 1790167690 | Wanda Al-lahabi | Specialist | 1030 St. Andrews Rd., Suite B-3, Columbia, SC 29210 | 2015-06-26 |
| 1285040279 | Debra R. Smart | Counselor | 652 Bush Road, Suite 216, Columbia, SC 29210 | 2014-07-10 |
| 1144665282 | Snf Transportation LLC | Home Health | 810 Dutch Center Blvd, Columbia, SC 29210 | 2013-05-02 |
| Find all providers in zip 29210 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841806551 | Pamela Louise Smith | Nurse Practitioner | 1605 E Broadway Ste 100, Columbia, MO 65201-8023 | 2020-09-17 |
| 1518572353 | Lucretia D Sanders | Nurse Practitioner | 4201 Grand St Apt L, Columbia, SC 29203-6668 | 2020-09-09 |
| 1629698485 | Abigayle Idora Colon | Nurse Practitioner | 55 Burnett Rd, Columbia, KY 42728-9441 | 2020-04-22 |
| 1245864321 | Mh Health Care Services, PC | Nurse Practitioner | 400 Laurel St Lowr Level, Columbia, SC 29201-2281 | 2020-02-27 |
| 1649801994 | Jennifer Turner | Nurse Practitioner | 1220 Hardison Rd, Columbia, TN 38401-1350 | 2020-01-27 |
| 1700429453 | Tyease Mosley | Nurse Practitioner | 4611 Hard Scrabble Rd Ste 189, Columbia, SC 29229-8584 | 2019-10-25 |
| 1164985834 | Rameka M Reed | Nurse Practitioner | 2301 Blue Ridge Ter, Columbia, SC 29203-1303 | 2019-04-10 |
| 1366917924 | Brittney Nichole Frazier | Nurse Practitioner | 3020 Sunset Blvd West Columbia Sc 29169, Columbia, SC 29203-2920 | 2018-10-10 |
| 1295224871 | Palmetto Health - University of South Carolina Medical Group | Nurse Practitioner | 2113 Adams Grv Ste 200, Columbia, SC 29203-6957 | 2018-05-09 |
| 1730698580 | Jennifer Moon Bailey | Nurse Practitioner | 237 Longtown Rd, Columbia, SC 29229-8550 | 2017-09-25 |
| Find all providers in COLUMBIA | ||||
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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.