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Export Provider Record NPI 1104893809
Celeste Reese WillisMD
Active
NPI Number1104893809
NPI TypeNPI-1 Individual
SpecialtyFamily Medicine
Provider Details
NPI1104893809
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2006-03-02
Last Updated2024-09-26
Mailing Address944 Narrows Point Dr
Birmingham, AL 35242-8672
United States
Phone: (205) 291-8842 | Fax: (205) 235-9592
📍 View Map
Primary Practice Address401 Tuscaloosa Ave Sw Ste 210
Birmingham, AL 35211-1486
United States
Phone: (205) 291-8842 | Fax: (205) 235-9592
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDAL009938946
Other (non-Medicare)167582201Federal Black Lung
Other (non-Medicare)AL51536439BCBS
Other (non-Medicare)AL631053058026Tricare
Other (non-Medicare)783802Aetna
Other (non-Medicare)ALI16326Healthspring of Al
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes207Q00000X – Family MedicineAL26026
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About NPI 1104893809

Celeste Reese Willis MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1104893809. The primary specialty listed is Family Medicine. The provider is located in Birmingham, AL. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-03-02. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1104893809?

NPI 1104893809 belongs to Celeste Reese Willis MD, a Family Medicine in Birmingham, AL. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1104893809 active?

The current status of NPI 1104893809 in the NPPES registry is Active. The record was last updated on 2024-09-26.

What specialty is NPI 1104893809?

NPI 1104893809 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1104893809?

You can verify NPI 1104893809 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1104893809?

The primary practice address on file for NPI 1104893809 is 401 Tuscaloosa Ave Sw Ste 210, Birmingham, AL 35211-1486. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1104893809 issued?

NPI 1104893809 was first issued (enumerated) on 2006-03-02. The NPPES record was last updated on 2024-09-26.

Practice Location Map

Celeste Reese Willis is located at 401 Tuscaloosa Ave Sw Ste 210, Birmingham, AL. Use the map below to find directions or verify the practice location.

📍 401 Tuscaloosa Ave Sw Ste 210, Birmingham, AL 35211-1486  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Celeste Reese Willis. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1104893809. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Family Medicine26026AL
Data Verified from CMS NPPES Last synced: 2026-06-26 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162