1. Home
  2. Directory
  3. Arizona
  4. Green Valley
  5. General Practice
  6. NPI Profile

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

Active since October 13, 2009PECOS Enrolled
1260 S CAMPBELL AVE BLDG 2, GREEN VALLEY, AZ 85614(520) 407-5400(520) 407-5990 Get Directions Write a Review

NPPES record last updated: August 23, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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
Open in Google Maps ↗

Other Identifiers 1

Other01WCFBXA1AZ · Medicare Billing No.

Medicare Participation & PECOS CMS

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

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.

Medicare Billing Reassignments

4

Medicare enrollment records show Willard Vannostrand reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Benson Hospital Corporation
40 mi
Critical Access
450 S OCOTILLO AVE
Benson, AZ 85602
  • Reassigned Medicare billing, Arizona enrollment
  • 152 clinicians in this Medicare group
NPI 1336118322 (520) 586-2261
Nes Arizona Inc
40 mi
Emergency Medicine
450 S OCOTILLO AVE
Benson, AZ 85602
  • Reassigned Medicare billing, Arizona enrollment
  • 60 clinicians in this Medicare group
NPI 1205217700 (520) 586-2261
Bisbee Hospital Association
60 mi
Rural Health
10524 E HIGHWAY 92
Hereford, AZ 85615
  • Reassigned Medicare billing, Arizona enrollment
  • 128 clinicians in this Medicare group
NPI 1225438104 (520) 366-0300
Navajo Health Foundation-Sage Memorial Hospital, Inc.
278 mi
Rural
ARIZONA HIGHWAY 191
Ganado, AZ 86505
  • Reassigned Medicare billing, Arizona enrollment
  • 204 clinicians in this Medicare group
NPI 1477735777 (928) 755-4500

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

Other Providers at the Same Location NPPES 8

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)
1260 S CAMPBELL AVE BLDG 2
GREEN VALLEY, AZ 85614
Pima County (520) 407-5400
ERNESTO GUTIERREZ MD
Internal Medicine
1260 S CAMPBELL AVE BLDG 2
GREEN VALLEY, AZ 85614
Pima County (520) 407-5400
LINDSAY ANN BOUCHARD DNP, PMHNP-BC, RN
Nurse Practitioner (Psychiatric/Mental Health)
1260 S CAMPBELL AVE BLDG 2
GREEN VALLEY, AZ 85614
Pima County (520) 407-5400
LUIS F LOZANO PA
Physician Assistant
1260 S CAMPBELL AVE BLDG 2
GREEN VALLEY, AZ 85614
Pima County (520) 407-5600
KI ALEXANDRA SLUSHER DNP, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1260 S CAMPBELL AVE BLDG 2
GREEN VALLEY, AZ 85614
Pima County (520) 407-5400
NANCY RILEY-WILLIAMS FNP-BC
Nurse Practitioner (Family)
1260 S CAMPBELL AVE BLDG 2
GREEN VALLEY, AZ 85614
Pima County (520) 407-5600
GREG JAMES REINHART PA-C
Physician Assistant
1260 S CAMPBELL AVE BLDG 2
GREEN VALLEY, AZ 85614
Pima County (502) 407-5400
CLARE HOFFORD
Nurse Practitioner (Family)
1260 S CAMPBELL AVE BLDG 2
GREEN VALLEY, AZ 85614
Pima County (520) 407-5611

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 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.

Where is Willard Vannostrand located?

Willard Vannostrand practices at 1260 S Campbell Ave Bldg 2, Green Valley, AZ 85614. The listed phone number is (520) 407-5400.

What is Willard Vannostrand's specialty?

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

Is Willard Vannostrand enrolled in Medicare?

Yes. Willard Vannostrand is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Willard Vannostrand's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Willard Vannostrand reassigns Medicare benefits to 4 organizations: Benson Hospital Corporation (Benson, AZ), Nes Arizona Inc (Benson, AZ), Bisbee Hospital Association (Hereford, AZ) and Navajo Health Foundation-Sage Memorial Hospital, Inc. (Ganado, AZ). Each 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 Willard Vannostrand'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 Willard Vannostrand was last updated on August 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.