WILLIS CLINIC PLLC
NPI 1063619567
Clinic/Center - Primary Care in Osceola, AR

Active since June 28, 2007CLIA 04D1087968 · Waiver
616 W LEE AVE, OSCEOLA, AR 72370(870) 563-2545(870) 563-2482 Get Directions Write a Review

NPPES record last updated: January 20, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 20, 2021, Jan 13, 2021, Dec 29, 2020 and 1 more (4 updates tracked since 2019).

About Willis Clinic Pllc NPPES

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

WILLIS CLINIC PLLC (NPI 1063619567) is a healthcare organization registered as a primary care in Osceola, Arkansas and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through August 13, 2026 and lists Timothy W Willis, Coo/practice Manager, as its authorized official.

NPPES Registry Identity

NPI1063619567
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameWILLIS CLINIC
Location Address616 W LEE AVEOsceola, AR 72370-3002
Mailing Address616 W Lee AveOsceola, AR 72370-3002 · (870) 563-2545 · Fax (870) 563-2482
Fax(870) 563-2482
Organization SubpartNo
Authorized OfficialTimothy W WillisCoo/practice Manager · (870) 563-2545
Enumeration DateJune 28, 2007
Last NPPES UpdateJanuary 20, 20214 updates tracked since enumeration
NPPES CertifiedJanuary 20, 2021
NPI 1063619567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License Licensed in AR · E5031
616 W LEE AVE, Osceola, AR 72370

Other Names 1

Doing Business AsWillis Clinic Pllc

Other Identifiers 1

Medicaid165422001AR

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D1087968

Willis Clinic PLLC · Osceola, AR
Active · expires Aug 13, 2026
CLIA Number04D1087968
Laboratory TypePhysician Office
Certificate Effective DateAugust 14, 2024
Certificate Expiration DateAugust 13, 2026
Laboratory DirectorSherita D. Willis
Laboratory Phone(870) 563-2545
Laboratory LocationWillis Clinic PLLC616 West Lee Ave, Osceola, AR 72370
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Clinic/Center (Urgent Care)
616 W LEE AVE, STE 2A
OSCEOLA, AR 72370
Family Medicine
616 W LEE AVE
OSCEOLA, AR 72370

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 Willis Clinic's NPI number?

The NPI number for Willis Clinic is 1063619567. It was assigned to this organization in the NPPES registry on June 28, 2007. The provider is doing business as Willis Clinic PLLC.

Where is Willis Clinic located?

Willis Clinic is located at 616 W Lee Ave, Osceola, AR 72370. The listed phone number is (870) 563-2545.

What is Willis Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Willis Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D1087968) is associated with this NPI, valid through August 13, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Willis Clinic accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Willis Clinic as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Willis Clinic was last updated on January 20, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.