MRS. DEONNA G WILLIS APRN
NPI 1972186880
Nurse Practitioner - Family in Lake City, FL

Q: What is Deonna Willis's NPI number?

The NPI number for Deonna Willis is 1972186880. It was assigned to this individual provider in the NPPES registry on April 29, 2021.

Q: What is Deonna Willis's specialty?

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

Q: Is Deonna Willis enrolled in Medicare?

No. Deonna Willis has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Deonna Willis was last updated on December 1, 2021. 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.

Active since April 29, 2021Opted out of Medicare · through Apr 1, 2027

404 NW HALL OF FAME DR, LAKE CITY, FL 32055(386) 719-2540 Get Directions Write a Review

NPPES record last updated: December 1, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 1, 2021, Oct 20, 2021, Apr 29, 2021 (3 updates tracked since 2021).

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About Mrs. Deonna G Willis Aprn NPPES

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

MRS. DEONNA G WILLIS APRN (NPI 1972186880) is an individual family provider in Lake City, Florida, licensed in Florida (APRN11012889) and active in the NPI registry since April 2021. She has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1972186880

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMRS. DEONNA G WILLISCredential: APRN

Location Address404 NW HALL OF FAME DRLake City, FL 32055-4833

Mailing Address404 Nw Hall Of Fame DrLake City, FL 32055-4833 · (386) 719-2540 · Fax (386) 752-9073

Phone(386) 719-2540

Sole ProprietorNo

Enumeration DateApril 29, 2021

Last NPPES UpdateDecember 1, 20213 updates tracked since enumeration

NPPES CertifiedDecember 1, 2021

✔ NPI 1972186880 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 FL · APRN11012889

404 NW HALL OF FAME DR, Lake City, FL 32055

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Deonna G Willis Aprn has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2023 through April 1, 2027.

Opt-Out Effective DateApril 1, 2023

Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32055 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$21.30 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier20 claims20 services$8.57 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$119.41 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

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