DR. WILLARD RANDOLPH VANNOSTRAND III M.D. - NPI 1922333772 - General Practice in Green Valley, AZ

Q: What is Willard Vannostrand's NPI number?

The NPI number for Willard Vannostrand is 1922333772. It was assigned to this individual provider in the NPPES registry on October 13, 2009.

Q: What is Willard Vannostrand's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

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About Dr. Willard Randolph Vannostrand Iii M.d. NPPES

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

DR. WILLARD RANDOLPH VANNOSTRAND III M.D. (NPI 1922333772) is an individual general practice provider in Green Valley, Arizona, licensed in Arizona (7028) and active in the NPI registry since October 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1922333772

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameDR. WILLARD RANDOLPH VANNOSTRAND IIICredential: M.D.

Location Address1260 S CAMPBELL AVE BLDG 2Green Valley, AZ 85614-0502

Mailing Address1260 S Campbell Ave Bldg 2Green Valley, AZ 85614-0502 · (520) 407-5600 · Fax (520) 407-5990

Phone(520) 407-5400

Fax(520) 407-5990

Sole ProprietorYes

Enumeration DateOctober 13, 2009

Last NPPES UpdateAugust 23, 2022

NPPES CertifiedJune 14, 2022

✔ NPI 1922333772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in AZ · 7028

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

1260 S CAMPBELL AVE BLDG 2, Green Valley, AZ 85614

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Other Identifiers 1

Other01WCFBXA1AZ · Medicare Billing No.

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Willard Randolph Vannostrand Iii M.d. 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 9

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

DR. ASHLEY N. HOLTON FNP-C, PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)