Brenda Sue Willis (NPI# 1831372721, PAC ID# 8628238326) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1831372721 |
| PAC ID by PECOS | 8628238326 |
| Professional Enrollment ID | I20120404000011 |
| Full Name | Brenda Sue Willis |
| Organization Legal Name | COASTAL SOUTHEASTERN UNITED CARE LLC |
| Address |
1040 X Ray Dr Gastonia NC 28054-7488 |
| Phone Number | 7042155822 |
| Gender | F |
| Medical School | UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE |
| Graduation Year | 1984 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 6204089188 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 10 Referendum Dr Ne, F 115, Bolivia, NC 28422-7579 | 9102535801 | COASTAL SOUTHEASTERN UNITED CARE LLC |
| 1040 X Ray Dr, Gastonia, NC 28054-7488 | 7042155822 | COASTAL SOUTHEASTERN UNITED CARE LLC |
| Organization Legal Name | COASTAL SOUTHEASTERN UNITED CARE LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth Barton | Nurse Practitioner | Coastal Southeastern United Care LLC | 3640 Express Dr, Shallotte, NC 28470-6501 |
| Sheila Cannon | Nurse Practitioner | Coastal Southeastern United Care LLC | 30 Drakes Branch Dr, Pembroke, NC 28372-7325 |
| Brittany Carol Barnes | Clinical Social Worker | Coastal Southeastern United Care LLC | 818 S Main St, Bladenboro, NC 28320-5970 |
| Kathy Asbury | Nurse Practitioner | Coastal Southeastern United Care LLC | 10 Referendum Dr Ne, F 115, Bolivia, NC 28422-7579 |
| Meredith Morrow Hartsell | Nurse Practitioner | Coastal Southeastern United Care LLC | 10 Referendum Dr Ne, F 115, Bolivia, NC 28422-7579 |
| Lunsford R King Jr. | Psychiatry | Coastal Southeastern United Care LLC | 3640 Express Dr, Shallotte, NC 28470-6501 |
| Michelle L Perkins | Clinical Social Worker | Coastal Southeastern United Care LLC | 30 Drakes Branch Dr, Pembroke, NC 28372-7325 |
| David Alan Joseph | Psychiatry | Coastal Southeastern United Care LLC | 30 Drakes Branch Dr, Pembroke, NC 28372-7325 |
| Street Address |
1040 X RAY DR |
| City | GASTONIA |
| State | NC |
| Zip | 28054-7488 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Albert Whitaker Jr. | Family Medicine | 224 S New Hope Rd K, Gastonia, NC 28054-0020 | |
| Leanne R King | Nurse Practitioner | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Kirsten G D Amore | Physical Medicine and Rehabilitation | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Emily B Rayfield | Nurse Practitioner | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| James E Harris Jr. | Physician Assistant | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Julie C Cornwell | Nurse Practitioner | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Lisa B Wilbanks | Nurse Practitioner | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Rebecca H Brown | Family Practice | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Nora D Paysour | Nurse Practitioner | Caromont Medical Group Inc | 258 E Garrison Blvd, Suite 101, Gastonia, NC 28054-0460 |
| Sharon L Heinrich | Nurse Practitioner | Hospice of Gaston County Inc | 258 E Garrison Blvd, Gastonia, NC 28054-0460 |
| Find all physicians in zip 28054 | |||
| City | GASTONIA |
| Zip Code | 28054 |
| Specialty | PSYCHIATRY |
| City + Specialty | GASTONIA + PSYCHIATRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.