Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dakotah Willis, PA-C

Individual provider Physician Assistant · NPI 1053005959

Dakotah Willis, PA-C is a Physician Assistant in Jackson, Tennessee. Qualified in 2022, 4 years ago. Practices with West Tennessee Medical Group Inc, a 190-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
4
Licensed in
TN
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

657 Skyline Dr
Jackson, TN 38301-3907
Phone: (731) 541-2250
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5329 (TN)

Record details

NPI number1053005959
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 5, 2023
Last updated in NPPESDecember 3, 2024
Certification dateDecember 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice West Tennessee Medical Group Inc — 190 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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