ERICK J WILLIS (NPI# 1912111097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912111097 |
| Entity Type | Individual |
| Full Name | ERICK J WILLIS |
| Credential | MD |
| Practice Address |
2828 First Avenue Suite 305 Huntington WV 25702 |
| Mailing Address |
Po Box 4190 Barboursville WV 25504-4190 |
| Practice Telephone | 3043997565 |
| Practice Fax Number | 3043997568 |
| Mailing Telephone | 3043994405 |
| Mailing Fax Number | 3043992526 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2018-04-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 23279 | WV | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 99999 | WV | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 000000245860 | 05 | |
| WV | CARELINK | 878669 | 01 |
| WV | AETNA | 9865182 | 01 |
| OH | 2909820 | 05 | |
| WV | 3810012988 | 05 | |
| WV | CIGNA | 6570317 | 01 |
| KY | 7100066820 | 05 | |
| WV | BRICKSTREET | 1073527 | 01 |
| Street Address |
2828 FIRST AVENUE SUITE 305 |
| City | HUNTINGTON |
| State | WV |
| Zip Code | 25702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902976863 | A Nedra Yulonda Fuller Terry | Podiatrist | 2828 First Avenue, Suite 203, Huntington, WV 25702-1236 | 2006-11-08 |
| 1124232954 | Jami E. Green | Family Medicine | 2828 First Avenue, Suite 510, Huntington, WV 25701 | 2007-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629692306 | Jessica Nicole Hankins | Social Worker | 2769 Collins Avenue, Huntington, WV 25702 | 2020-05-29 |
| 1932750338 | Dasllastiene Cabell | Technician | 6188 Little 7 Mile Rd, Huntington, WV 25702 | 2019-09-26 |
| 1295386134 | Hope Vance | Technician | 2 Sam Collins Road, Huntington, WV 25702 | 2019-09-23 |
| 1649726373 | Erin Nicole Wingate | Emergency Medicine | 2828 1st Ave., Huntington, WV 25702 | 2016-09-01 |
| 1639545510 | Ready Set Relax LLC | Massage Therapist | 2411 3rd Avenue, Huntington, WV 25702 | 2015-08-14 |
| 1780709923 | M N Saleme Surgery Inc | Surgery | 2828 First Ave, Suite 205, Huntington, WV 25702 | 2007-03-20 |
| 1558496489 | Rajendra K Jain Urology Inc | Urology | 2828 First Ave Suite 204, Huntington, WV 25702 | 2007-02-22 |
| 1578621678 | Andrea R Ferguson | Registered Nurse | 2860 3rd Ave Suite 10, Huntington, WV 25702 | 2006-12-04 |
| 1588742688 | Tri State Neurology Pllc | Psychiatry & Neurology | 2860 Third Ave, Suite 20, Huntington, WV 25702 | 2006-11-02 |
| 1790889905 | All Med LLC | Durable Medical Equipment & Medical Supplies | 410 Seventh Ave, Huntington, WV 25702 | 2006-09-08 |
| Find all providers in zip 25702 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205126158 | Arthur Jay Schwager | Pediatrics | 21 Grouse Ln, Huntington, NY 11743-1028 | 2011-04-12 |
| 1770797839 | Sean Loudin | Pediatrics | 1600 Medical Center Drive, Ste 3500, Huntington, WV 25701 | 2007-05-09 |
| 1023048667 | Eileen P Sheehy | Pediatrics | 164 East Main Street, Huntington Pediatrics PC, Huntington, NY 11743 | 2006-07-03 |
| 1215980487 | Bruce Edward Gerberg | Pediatrics | 41 Fairview St, Huntington, NY 11743-3552 | 2006-05-18 |
| 1891759759 | Jacqueline R Ray | Pediatrics | 2915 3rd Ave, Huntington, WV 25702-1401 | 2006-04-17 |
| 1922062942 | James M Lewis | Pediatrics | 2915 Rear 3rd Ave, Huntington, WV 25702 | 2006-04-14 |
| 1639132418 | Duane A Hougendobler | Pediatrics | 2003 Stults Road, Suite 105, Huntington, IN 46750-1291 | 2006-04-11 |
| 1063475853 | Lourdu Selvaraj Savariar | Pediatrics | 2814 Theater Ave, Pediatric Medical Group Inc, Huntington, IN 46750-7978 | 2006-04-11 |
| 1760454656 | Lee A. Kurfist | Pediatrics | 205 East Main Street, Suite 2-8, Huntington, NY 11743-2923 | 2006-02-03 |
| 1265419436 | Balaji Govindaswami | Pediatrics | 1600 Medical Center Dr Ste 3500, Huntington, WV 25701-3655 | 2005-12-28 |
| Find all providers in HUNTINGTON | ||||
| City | HUNTINGTON |
| Zip Code | 25702 |
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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.