Individual provider

Simon Willis, M.D.

Pain Medicine (Physical Medicine & Rehabilitation) Physician Medicare enrolled

Simon Willis, M.D. is a Pain Medicine (Physical Medicine & Rehabilitation) Physician in Pooler, GA, registered under NPI 1356761191.

Getting there

The practice address on file is 114 CANAL ST STE 503, Pooler, GA 31322. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

114 CANAL ST STE 503, Pooler, GA 31322 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
84680 GA Pain Medicine (Physical Medicine &… primary
83377 SC Pain Medicine (Physical Medicine &…

Licences are recorded in 2 states: GA, SC. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Physical Medicine And Rehabilitation
PAC ID
3476805060

Enrolled in Medicare 2 times, across 2 states:

StateEnrollment IDProvider type
Colorado I20190806001655 Practitioner - Physical Medicine And Rehabilitation
South Carolina I20200420000010 Practitioner - Physical Medicine And Rehabilitation

Medicare enrolment is recorded as approved under the provider type Practitioner - Physical Medicine And Rehabilitation. There are 2 separate enrolment records across 2 states (CO, SC). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Georgia and South Carolina. The practice address on file is in Pooler, GA, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

GA Georgia practice address
Licence
84680
Specialty
Pain Medicine (Physical Medicine &…
Verify with the GA board →
SC South Carolina
Licence
83377
Specialty
Pain Medicine (Physical Medicine &…
Verify with the SC board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Pain Medicine covers

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. NUCC Health Care Provider Taxonomy, code 2081P2900X
Allopathic & Osteopathic Physicians Physical Medicine & Rehabilitation Pain Medicine

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
2081P2900X Pain Medicine (Physical Medicine & Rehabilitation) Physician Pain Medicine 84680 GA primary
2081P2900X Pain Medicine (Physical Medicine & Rehabilitation) Physician Pain Medicine 83377 SC

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1356761191 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateApr 20, 2014
Last updatedApr 16, 2020
StatusActive
Sole proprietorNo
CredentialM.D.
Practice address 114 CANAL ST STE 503
Pooler, GA 31322
(912) 450-6300
Fax (912) 450-6303
The last update on file is Apr 16, 2020. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1356761191 passes the NPI check digit test The final digit 1 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 3 5 6 7 6 1 1 9
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 3 1 6 5 6 2 1 9

Sum = 59 · next multiple of 10 = 60 · check digit = 1 · actual last digit = 1

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1356761191?
NPI 1356761191 is the National Provider Identifier assigned to Simon Willis, M.D. in Pooler, GA. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Pain Medicine cover?
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
How do I contact Simon Willis, M.D.?
The phone number on file with NPPES is (912) 450-6300, last updated Apr 16, 2020. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Simon Willis, M.D. accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1356761191 a valid number?
Yes. 1356761191 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.