KOURTNEY MARIE WILLETT PA-C
NPI 1326691957
Physician Assistant - Surgical in Longview, TX

Q: What is Kourtney Willett's NPI number?

The NPI number for Kourtney Willett is 1326691957. It was assigned to this individual provider in the NPPES registry on July 23, 2019.

Q: What is Kourtney Willett's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Kourtney Willett was last updated on November 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 23, 2019PECOS Enrolled

912 WALNUT HILL DR, LONGVIEW, TX 75605(903) 291-6300 Get Directions Write a Review

NPPES record last updated: November 18, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 18, 2025, Sep 24, 2019, Jul 23, 2019 (3 updates tracked since 2019).

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About Kourtney Marie Willett Pa-c NPPES

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

KOURTNEY MARIE WILLETT PA-C (NPI 1326691957) is an individual surgical provider in Longview, Texas, licensed in Texas (PA12883) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1326691957

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameKOURTNEY MARIE WILLETTCredential: PA-C

Location Address912 WALNUT HILL DRLongview, TX 75605-5052

Mailing Address912 Walnut Hill DrLongview, TX 75605-5052 · (903) 291-6300

Phone(903) 291-6300

Sole ProprietorNo

Enumeration DateJuly 23, 2019

Last NPPES UpdateNovember 18, 20253 updates tracked since enumeration

NPPES CertifiedNovember 18, 2025

✔ NPI 1326691957 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in TX · PA12883

912 WALNUT HILL DR, Longview, TX 75605

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kourtney Marie Willett Pa-c 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.

Other Providers at the Same Location NPPES 11

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

RYAN M GUILLORY MD

Otolaryngology