MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER) – Family Nurse Practitioner, NPI 1023345410

MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER) is a healthcare provider. based in Albany, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NURSE PRACTITIONER. They hold a License No. RN141960 (GA). The NPI Number for MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER) is 1023345410

Main info

Female
17 Years Of Experience
Accepts Medicare Assignment
Name
MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER)
NPI
1023345410
Phone
(229) 434-2173
Address
2000 PALMYRA RD
Enumeration Date
6 November 2009
Last Update Date
6 November 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2293128750
Graduation Year
2009 (17 years ago)
PAC ID
9436477395
Group Practice PAC ID
8426112350
Professional Enrollment ID
I20150406001939
Address ID
GA317072801AL2336XRDXX302
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

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Provider Addresses for MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER)

  • Phoebe Putney Memorial Hospital North Campus, 2000, Palmyra Road, Albany, Dougherty County, Georgia, 31701, United States

    ALBANY, GA 317011528

    Phone: (229) 434-2173

    Fax: (229) 434-2548

    Mailing address matches the actual address.

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: 2015-04-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150406001939INurse PractitionerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31701)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426112350View full group profile
NameSpecialtyState
-GA
Nurse PractitionerGA
-GA
Internal MedicineGA
-GA
Certified Registered Nurse Anesthetist (Crna)GA
Internal Medicine, Critical Care (Intensivists), Infectious DiseaseIN
Internal MedicineGA
Internal MedicineGA
Pulmonary Disease, Internal MedicineFL

Reviews

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Frequently asked questions

What is MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER)'s NPI number?
MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER)'s NPI is 1023345410 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER)?
You should see MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER) as active in CMS-hosted NPPES data.
What expertise is attributed to MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER)?
MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER)'s specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER) associated with Albany?
Public fields place MS. BEVERLY ANN WILLIS (NURSE PRACTITIONER) around Albany, Georgia. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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