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MRS. MISTY FAULK WILLIS NURSE PRACTITIONER
NPI 1053645697
Nurse Practitioner - Family in Americus, GA

Active since September 30, 2009PECOS Enrolled
609 E LAMAR ST, AMERICUS, GA 31709(229) 924-8636(229) 924-8786 Get Directions Write a Review

NPPES record last updated: August 2, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Misty Faulk Willis Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MISTY FAULK WILLIS NURSE PRACTITIONER (NPI 1053645697) is an individual family provider in Americus, Georgia, licensed in Georgia (RN177038) and active in the NPI registry since September 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053645697
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. MISTY FAULK WILLISCredential: NURSE PRACTITIONER
Location Address609 E LAMAR STAmericus, GA 31709-3737
Mailing Address609 E Lamar StAmericus, GA 31709-3737 · (229) 924-8636 · Fax (229) 924-8786
Phone(229) 924-8636
Fax(229) 924-8786
Sole ProprietorNo
Enumeration DateSeptember 30, 2009
Last NPPES UpdateAugust 2, 2023
NPPES CertifiedAugust 2, 2023
✔ NPI 1053645697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · RN177038
609 E LAMAR ST, Americus, GA 31709
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Misty Faulk Willis Nurse Practitioner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Misty Willis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Careconnect Health, Inc.
26 mi
Federally Qualified Health Center (FQHC)
510 ALSTON ST STE B
Richland, GA 31825
  • Reassigned Medicare billing, Georgia enrollment
  • 219 clinicians in this Medicare group
NPI 1063436624 (229) 887-3324

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31709 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. QUAISON TRENTUS DEY M.D.
Pediatrics
609 E LAMAR ST
AMERICUS, GA 31709
Sumter County (229) 924-8636
DR. CHARLES ALONZO PETERS JR. MD / PHD
Pediatrics
609 E LAMAR ST
AMERICUS, GA 31709
Sumter County (229) 924-8636
JAMI HODGES FNP-C
Nurse Practitioner (Family)
609 E LAMAR ST
AMERICUS, GA 31709
Sumter County (229) 924-8636

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Misty Willis's NPI number?

The NPI number for Misty Willis is 1053645697. It was assigned to this individual provider in the NPPES registry on September 30, 2009.

Where is Misty Willis located?

Misty Willis practices at 609 E Lamar St, Americus, GA 31709. The listed phone number is (229) 924-8636.

What is Misty Willis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Misty Willis enrolled in Medicare?

Yes. Misty Willis is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Misty Willis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Misty Willis reassigns Medicare benefits to Careconnect Health, Inc. (Richland, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Misty Willis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Misty Willis was last updated on August 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.