JAMES R WILLIS (NPI# 1407800501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407800501 |
| Entity Type | Individual |
| Full Name | JAMES R WILLIS |
| Credential | M.D. |
| Practice Address |
16 Woodbine Lane Danville PA 17822-8029 |
| Mailing Address |
100 N Academy Ave Danville PA 17822-4903 |
| Practice Telephone | 5702718050 |
| Mailing Telephone | 5702716144 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2020-08-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | M7012 | ID | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD054641L | PA | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
M7012 | ID | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
M7012 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 000278700 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 115 Woodbine Lane, Danville, PA 178225206 | 5702718050 | |
| 3810 Springhurst Blvd, Suite 200, Louisville, KY 402416100 | 5025831749 | 5023298184 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820881 | James Edwin Willis | Registered Nurse | 6057 W 41st Ave, Kennewick, WA 99338-0036 | 2020-04-21 |
| 1225308554 | James Robert Willis | Radiology | 56 Riverdale Dr, Covington, LA 70433-4523 | 2012-01-03 |
| 1104969807 | James Stewart Willis IIi | Counselor | 600 Jackson, Rappahannock Area Community Services Board, Fredericksburg, VA 22401 | 2007-02-14 |
| 1669536066 | James Timothy Willis | Chiropractor | 403 N Crawford St, Thomasville, GA 31792-5128 | 2006-12-20 |
| 1538153127 | James Allen Willis | Anesthesiology | 11971 Heritage Oak Pl, Auburn, CA 95603-2461 | 2005-09-09 |
| 1154322915 | James L. Willis | Family Medicine | 1741 David Walker Dr, Tavares, FL 32778-5745 | 2005-08-02 |
| 1720084064 | James B Willis | Dentist | 102 1st Ave E, Polson, MT 59860-2335 | 2005-06-22 |
| 1982186268 | James Willis | Specialist/Technologist | 133 N River St, City of Wilkes Barre, PA 18702-2404 | 2018-09-03 |
| 1528512696 | James L Willis Jr. | Registered Nurse | 505 S Main St Ste 249, Las Cruces, NM 88001-1243 | 2016-08-06 |
| 1821447699 | James Willis | Case Manager/Care Coordinator | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2016-06-12 |
| Street Address |
16 WOODBINE LANE |
| City | DANVILLE |
| State | PA |
| Zip Code | 17822-8029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164417184 | Jared W Schneider | Optometrist | 16 Woodbine Lane, Danville, PA 17822-8029 | 2005-09-15 |
| 1083277834 | Kayla Jean Riswold | Student in an Organized Health Care Education/Training Program | 16 Woodbine Lane, Danville, PA 17822-1554 | 2019-04-17 |
| 1437636354 | Jill Susan Sweigard | Nurse Practitioner | 16 Woodbine Lane, Danville, PA 17822-1154 | 2018-07-24 |
| 1164921631 | Liberty Woodruff Deegan | Physician Assistant | 16 Woodbine Lane, Danville, PA 17822-9800 | 2018-02-09 |
| 1316462864 | Matthew James Delong | Optometrist | 16 Woodbine Lane, Danville, PA 17822-9118 | 2017-08-06 |
| 1396270096 | Oksana Bailiff | Student in an Organized Health Care Education/Training Program | 16 Woodbine Lane, Danville, PA 17822 | 2017-05-01 |
| 1821521733 | Radhika Rani Trivedi | Dermatology | 16 Woodbine Lane, Danville, PA 17822 | 2017-04-07 |
| 1235660952 | Frank Zurfley Jr. | Dermatology | 16 Woodbine Lane, Geisinger/dermatology, Danville, PA 17821 | 2017-03-23 |
| 1932642949 | Rachael Jane Palazzo | Physician Assistant | 16 Woodbine Lane, Danville, PA 17822-2910 | 2016-11-22 |
| 1902256274 | Gisland Montour | Physical Medicine & Rehabilitation | 16 Woodbine Lane, Danville, PA 17822-3323 | 2016-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366062895 | Staci Lee Benoit | Student in an Organized Health Care Education/Training Program | 100 North Academy Avenue Geisinger Medical Center, Danville, PA 17822 | 2020-04-24 |
| 1275162018 | Kristena Yossef | Student in an Organized Health Care Education/Training Program | Geisinger Medical Center, 100 North Academy Avenue, Da, Danville, PA 17822 | 2020-04-03 |
| 1003470444 | Intekhab Askari Syed Ahmad Raza | Student in an Organized Health Care Education/Training Program | 100 North Academy Avenue, Geisinger Medical Center, Danville, PA 17822 | 2019-04-30 |
| 1841766334 | Sarah Louise Dearment | Counselor | Geisinger Medical Center: Department of Psychiatry, 100 N. Academy Avenue, Danville, PA 17822 | 2018-10-23 |
| 1548753908 | Josie Pervola | Genetic Counselor, MS | 100 N Academy Ave Mc-26-20, Danville, PA 17822 | 2018-06-11 |
| 1477059350 | Martha Niemiec | Counselor | Geisinger Medical Center Department of Psychiatry, 100 North Academy Avenue, Danville, PA 17822 | 2018-04-01 |
| 1730625450 | Nir Shimony | Neurological Surgery | 100 N. Academy Ave., Geisinger Medical Center, Neurosurgery Department, Danville, PA 17822 | 2017-01-19 |
| 1164877197 | Britta Hunter | Speech-Language Pathologist | 100 N. Academy Ave., Danville, PA 17822 | 2016-04-27 |
| 1891180725 | Zach Rottmann | Internal Medicine | Geisinger Medical Center, 100 North Academy Avenue, Danville, PA 17822 | 2015-03-30 |
| 1891063251 | John D Chakan | Pharmacist | 1000 S Second St, Sunbury, PA 17822 | 2011-12-13 |
| Find all providers in zip 17822 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538600853 | Dermone Dermatology Associates of The Keystone State, P.c | Dermatology | 200 Barr Harbor Drive, Four Tower Bridge, Suite 200, West Conshohocken, PA 19428 | 2017-03-20 |
| 1962802249 | Carlisle Dermatology Group | Dermatology | 19 Sprint Drive, Suite 1, Carlisle, PA 17015-7002 | 2014-08-24 |
| 1922418516 | Veronica Rutt | Dermatology | 1665 Valley Center Pkwy Ste 120, Bethlehem, PA 18017-2353 | 2014-05-05 |
| 1003109059 | Amanda Joy Tschetter | Dermatology | 575 Coal Valley Rd Ste 360, Clairton, PA 15025-3739 | 2011-05-24 |
| 1871893529 | Accurate Dermatology Pa, LLC | Dermatology | 2805 Fringe Lane, Easton, PA 18040 | 2010-10-28 |
| 1134393028 | Paul Xavier Benedetto | Dermatology | 2221 Garrett Rd, Drexel Hill, PA 19026-1101 | 2008-04-22 |
| 1558549733 | Keystone Dermatology & Center for Skin Surgery, LLC | Dermatology | 2525 9th Ave Ste 2, Altoona, PA 16602-2014 | 2008-02-10 |
| 1710174511 | The Skin and Cancer Center | Dermatology | 18 Millridge Dr, Aston, PA 19014-1063 | 2007-09-26 |
| 1871785683 | Kevin Crouse, Md PC | Dermatology | 250 Pierce St Ste 217, Kingston, PA 18704-5149 | 2007-08-15 |
| 1326240557 | Marc Kevin Rubenzik | Dermatology | 233 S 10th St, Suite 450, Philadelphia, PA 19107-5541 | 2007-06-01 |
| 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.