CHARLES ADAM WILLIS FNP NPI 1659795151

NPI Information

NPI: 1659795151
Provider Name: CHARLES ADAM WILLIS, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: HEALTH EXPRESS

PECOS Registration: Yes

Address:
6419 BRISTOL HWY
PINEY FLATS, TN
ZIP 37686
Phone: (423) 538-5202
Get Directions

Charles Adam Willis, FNP is a family nurse practitioner in Piney Flats, TN with 11 years of experience. Charles Adam Willis, FNP NPI is 1659795151. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6419 BRISTOL HWY
PINEY FLATS, TN
ZIP 37686-208
Phone: (423) 538-5202
Fax: (423) 538-8208

The NPI 1659795151 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), Power Mobility Devices.

The enumeration date for this NPI number is 2/5/2014 and was last updated on 2/28/2017.

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
1	163W00000X	Registered Nurse		RN0000177156	TENNESSEE	No
2	363LF0000X	Nurse Practitioner	Family	18377	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	10370G9364	MEDICARE PIN	TENNESSEE
2	10350I3347	MEDICARE PIN	TENNESSEE
3	Q003839	MEDICAID	TENNESSEE

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: 11/14/2023

NPI Synchronization or Removal

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