WILLARD MARVIN III ANDERSON (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063756211
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for WILLARD MARVIN III ANDERSON (PMHNP)
3686 US HIGHWAY 331 S
DEFUNIAK SPRINGS, FL 324358463
Phone: (850) 892-8045
Type: Mailing
PO BOX 1559
MURFREESBORO, TN 371331559
Phone: (615) 278-2241
Fax: (615) 206-7587
Type: Mailing
1956 BARKER CAMP RD
DUNLAP, TN 373275939
Phone: (615) 568-5529
Fax: (850) 681-6003
Type: Mailing
459 GRACE AVE STE 100
PANAMA CITY, FL 324012757
Phone: (615) 568-5529
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-02-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130117000006 | I | Nurse Practitioner | FL | TBD |
| I20190227000381 | I | Nurse Practitioner | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 104 | 51 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 89 | 45 | $0 |
Insurance plans in this area (ZIP 32435)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | FL | 90792 | Psychiatric diagnostic evaluation with medical services | 20 | 20 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | FL | |
| Clinical Social Worker | FL | |
| - | FL | |
| Physician Assistant | FL | |
| General Practice, Family Practice | FL | |
| Clinical Social Worker | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| General Practice | FL | |
| Nurse Practitioner | FL |
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