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

Mr. Benjamin M Willy, ATC

Individual provider Athletic Trainer · NPI 1164854303

Mr. Benjamin M Willy, ATC is an Athletic Trainer in Jasper, Tennessee. Licensed in Arkansas and Tennessee. Registered with an NPI since 2013.

Licensed in
AR, TN
In the registry since
2013
Specialties on file
2
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

See every abbreviation used in this directory →

Practice location Address checks out

4150 Main St
Jasper, TN 37347-3445
Phone: (423) 942-8073
Fax: (423) 942-6660
Show map & directions

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

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2056 (TN)
Athletic Trainer Taxonomy 2255A2300X · Licence AT 558 (AR)

Record details

NPI number1164854303
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorNo
NPI enumeratedJuly 30, 2013
Last updated in NPPESMay 13, 2016
Mailing address8823 Production Ln, Ooltewah, TN 37363-6511