Willow Medical Clinic, LLC
NPI 1356507404ActiveOrganization· Physician Assistant, Medical· Manchester, TN
Physician Assistant, Medical in Manchester, Tennessee, registered in NPPES in July 2008. The authorized official on file is Tammy Shelley, Office Manager/Assist. Business Adm.
Overview
| NPI | 1356507404 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 29, 2008 |
| Last updated in NPPES | Jul 29, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | — | — |
| Nurse Practitioner, Family | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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