JENNY LYNN WILLIS (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1740659135

JENNY LYNN WILLIS (NP) is a healthcare provider. based in Virginia beach, Virginia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 0001227478 (VA). The NPI Number for JENNY LYNN WILLIS (NP) is 1740659135

Main info

Female
11 Years Of Experience
Name
JENNY LYNN WILLIS (NP)
NPI
1740659135
Phone
(757) 468-0550
Address
4854 HAYGOOD RD
Enumeration Date
16 September 2015
Last Update Date
23 May 2025

Doctor Profile

Medical School Name
STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Secondary Phone
7576488605
Graduation Year
2015 (11 years ago)
PAC ID
6608176730
Group Practice PAC ID
6709168776
Professional Enrollment ID
I20250421000404
Address ID
VA234516387VI1072XRDXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:10State licenses:2Digital endpointsOther names

8,303 NURSE PRACTITIONER in VA

Provider Addresses for JENNY LYNN WILLIS (NP)

  • 4854 HAYGOOD RD

    STE 101

    VIRGINIA BEACH, VA 234555351

    Phone: (757) 468-0550

    Fax: (757) 468-9992

    Type: Mailing

  • 1072 LASKIN RD STE 104

    VIRGINIA BEACH, VA 234516387

    Phone: (757) 648-8605

    Fax: (757) 648-1363

    Type: Mailing

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: 2025-04-21

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
I20250421000404INurse PractitionerVATBD

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 23455)

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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: 6709168776View full group profile
NameSpecialtyState
Clinical Social WorkerVA
Certified Clinical Nurse Specialist (Cns)VA
Nurse PractitionerVA
-VA
Clinical Social WorkerVA
Physician AssistantVA
Marriage And Family TherapistVA

Reviews

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Frequently asked questions

Does JENNY LYNN WILLIS (NP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — JENNY LYNN WILLIS (NP) uses 1740659135.
Is JENNY LYNN WILLIS (NP) still practicing?
JENNY LYNN WILLIS (NP) is currently listed as active in the public NPI registry.
What taxonomy line describes JENNY LYNN WILLIS (NP)?
For research purposes, treat JENNY LYNN WILLIS (NP) as Psychiatric/Mental Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does JENNY LYNN WILLIS (NP) serve?
JENNY LYNN WILLIS (NP)'s listing highlights Virginia Beach, Virginia; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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