Erik Willis

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

38097 Issued in OK

Practice address

900 NE 10TH St
Oklahoma City, OK 73104-5420

Phone

(405) 271-2230

NPI assigned

Sep 22, 2020

Last updated

Jul 26, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, OK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

University of Oklahoma College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Absentee Shawnee Tribal Health Authority, IncGroup PAC ID 5799171088, 83 clinicians

Lutheran Hospital Association of the San Luis ValleyGroup PAC ID 4789589094, 146 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Luis Valley Regional Medical Center Hospital, Alamosa, CO, CCN 060008

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Absentee Shawnee Tribal Health Authority, Inc.

  dba Absentee Shawnee Tribal Health System - Shawnee Clinic

  • Multi-Specialty Clinic/Center
  • Shawnee, OK
  • NPI 1942253521
  Medicare reassignment Care Compare group NPD
• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Medicare reassignment Care Compare group NPD
• Absentee Shawnee Tribal Health Authority, Inc.

  dba Absentee Shawnee Tribal Health System- Little Axe Health Center

  • Multi-Specialty Clinic/Center
  • Norman, OK
  • NPI 1124152962
  NPD
• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Stuart Avenue Clinic

  • Internal Medicine Physician
  • Alamosa, CO
  • NPI 1972556744

  Family Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1023624228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 NE 10TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045420",
            "telephone_number": "405-271-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NE 10TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045420",
            "telephone_number": "405-271-2230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 NE 14th St Apt C6",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731041236",
            "country_code": "US",
            "telephone_number": "918-520-5472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ERIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-22",
        "last_updated": "2021-07-26",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "38097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Jean Willis-Rednose
• Alyson Blake Willis, D.O.
• April Willis
• Bailey Reann Willis, PA
• Cynthia Willis
• Errin Desharm Willis
• Gennice Jenail Willis
• Guy Rance Willis, LCSW
• Heather Lynette Willis
• Kanisha Nicole Willis

• Family Medicine Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.