BEAU WILLIS DPM NPI 1396164679

NPI Information

  • NPI: 1396164679
  • Provider Name: BEAU WILLIS, DPM
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2520 HARVARD AVE FL 1
    METAIRIE, LA
    ZIP 70001
  • Phone: (504) 454-3004

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NPI Details

Beau Willis, DPM is a foot and ankle surgery podiatrist in Metairie, LA with 12 years of experience. Beau Willis, DPM NPI is 1396164679. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: BARRY UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduation Year:2014

The provider's business location address is:

2520 HARVARD AVE FL 1
METAIRIE, LA
ZIP 70001-172
Phone: (504) 454-3004
Fax: (504) 454-3075

The NPI 1396164679 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 4/15/2014 and was last updated on 6/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0103XPodiatristFoot & Ankle Surgery307117LOUISIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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