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

Dr. Devin R Willis, MD

Individual provider Sports Medicine (Family Medicine) Physician · NPI 1295175057

Dr. Devin R Willis, MD is a Sports Medicine in Wildwood, Missouri. Qualified in 2013, 13 years ago. Practices with Physician Groups Lc, a 524-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
13
Licensed in
MO
In the registry since
2013
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

16555 Manchester Rd Ste 100
Wildwood, MO 63040
Phone: (636) 458-0646
Fax: (636) 458-5008
Show map & directions

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

Additional practice locations (3)

  • 4921 Parkview Pl, Saint Louis, MO 63110 — (314) 747-2500
  • 11133 Dunn Rd Ste 2427, Saint Louis, MO 63136-6163 — (314) 653-5643
  • 16555 Manchester Rd Ste 110, Wildwood, MO 63040-1220 — (636) 405-3155

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence 2016023372 (MO)
Hospitalist Physician Taxonomy 208M00000X · Licence 2016023372 (MO)

Record details

NPI number1295175057
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 26, 2013
Last updated in NPPESNovember 10, 2022
Certification dateNovember 10, 2022
Mailing address16555 Manchester Rd Ste 100, Wildwood, MO 63040-1220

Medicare enrollment

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

Medicare specialtySPORTS MEDICINE
Also practisesFAMILY PRACTICE, HOSPITALIST
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Physician Groups Lc — 524 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount