JODI WILLIS (NPI# 1912186792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912186792 |
| Entity Type | Individual |
| Full Name | JODI WILLIS |
| Practice Address |
305 Wooley St Raeford NC 28376-3236 |
| Practice Telephone | 9108755074 |
| Practice Fax Number | 9108757694 |
| Mailing Telephone | 9108755074 |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-10-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8300027K | 05 |
| Street Address |
305 WOOLEY ST |
| City | RAEFORD |
| State | NC |
| Zip Code | 28376-3236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265528632 | Hoke Co Association for Develop Disabled Inc. | Day Training, Developmentally Disabled Services | 305 Wooley St, Raeford, NC 28376-3236 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578185104 | Elite Supply Services, Inc. | Durable Medical Equipment & Medical Supplies | 2148 Bus-us 401, Raeford, NC 28376 | 2020-05-18 |
| 1205485695 | Brenda P Gregorio | Technician | 297 Gregorios Ln, Raeford, NC 28376 | 2019-09-09 |
| 1083197115 | Jennifer Picerno Bowyer | Nurse Practitioner | 929 Prospect Ave., Raeford, NC 28376 | 2018-09-14 |
| 1730694746 | Embassy Health Network | Counselor | 2148 Hwy 401 Business, Raeford, NC 28376 | 2017-12-13 |
| 1508398991 | Rockfish Pharmacy Inc | Pharmacy | 221 Flagstone Lane, Raeford, NC 28376 | 2017-04-03 |
| 1205281235 | William Fiebig | Nurse Practitioner | Hoke Hospital, 210 Medical Pavilion Drive, Raeford, NC 28376 | 2016-04-27 |
| 1306200647 | Tia Hart Community Recovery Program | Community/Behavioral Health | 2188 A Us 401 Business, Raeford, NC 28376 | 2016-04-13 |
| 1508240631 | Integrated Mental Health Services Agency Inc | Community/Behavioral Health | 2188-a Hwy 401 Business, Raeford, NC 28376 | 2015-07-18 |
| 1649658287 | Divine Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 320 Birch St, Raeford, NC 28376 | 2015-05-15 |
| 1992192298 | David Abdulhaqq | Counselor | 225 Aggies Lane, Raeford, NC 28376 | 2015-04-24 |
| Find all providers in zip 28376 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578174355 | A Better You Wellness Center | Clinic/Center | 3103 Durant Rd, Greenville, NC 27834-6786 | 2020-08-13 |
| 1770118556 | Enable LLC | Clinic/Center | 4050 Legion Rd, Hope Mills, NC 28348-8872 | 2020-03-11 |
| 1083128508 | Almarch Family Care, LLC | Clinic/Center | 1924 Beverly Rd, Rocky Mount, NC 27801-6313 | 2017-11-20 |
| 1669995577 | L.a.s Learning Playhouse, LLC | Clinic/Center | 210 Craver Ave, Salisbury, NC 28146-5906 | 2017-07-23 |
| 1528314408 | Laura Maria Mckoy | Clinic/Center | 122 Live Oak Drive, Jacksonville, NC 28540 | 2012-07-30 |
| 1306123294 | Lane's House Adult Group Home | Clinic/Center | 3159 Octavia Dr, Rocky Mount, NC 27804-7959 | 2011-11-07 |
| 1639408248 | Self-determination LLC | Clinic/Center | 103 Ebenezer Rd, Kings Mtn, NC 28086 | 2009-12-09 |
| 1235388133 | Eaglemere Living Facility | Clinic/Center | 200 Eagles Mere Trl, Rocky Mount, NC 27804-8850 | 2008-09-16 |
| 1043468796 | Making It Happen, Inc. | Clinic/Center | 355 Ransom Rd, Winston Salem, NC 27106-3835 | 2008-09-07 |
| 1689841298 | Safe Harbour | Clinic/Center | 13 East Dr, Jacksonville, NC 28546-8214 | 2008-05-13 |
| Find all providers with the same taxonomy | ||||
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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.