NPIMap

Individual provider Active NPI

Edith Barrett Willis, PA-C

  • Physician Assistant
  • Charleston, SC
National Provider Identifier
1245584606
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1853 Issued in SC
Practice address
2060 Sam Rittenberg Blvd
Charleston, SC 29407-4616
Phone
(843) 792-1414
NPI assigned
Nov 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1853 SC Primary

Addresses

Primary practice location

2060 Sam Rittenberg Blvd
Charleston, SC 29407-4616

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-1414

Other names 1

  • Barrett Willis Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130110000440 SC Practitioner - Physician Assistant 4183877715 Reassigns benefits to 1 organization
I20171206003049 CA Practitioner - Physician Assistant 4183877715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2060 Sam Rittenberg Blvd
Charleston, SC 29407-4616
Phone (843) 792-1414

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
55063CAMDGeneral Practice Dentistry
1853SCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince Sep 1, 2025 Accepting new patients
Stanford Health Care CurrentSince Nov 28, 2017 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Sep 1, 2025 Accepting new patients
Stanford Health Care CurrentSince Nov 28, 2017 Accepting new patients

Locations

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

2060 Sam Rittenberg Blvd
Charleston, SC 29407
Phone (843) 876-0111

1122 Chuck Dawley Blvd
Bldg B
Mt Pleasant, SC 29464
Phone (843) 792-5434

5500 Front St
Summerville, SC 29486
Phone (843) 712-1414

Interoperability endpoints

  • Direct secure messaging: bwillis544256@direct.musc.edu

Organizations & group practices 5

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

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1245584606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 SAM RITTENBERG BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074616",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "EDITH",
        "middle_name": "BARRETT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2060 Sam Rittenberg Blvd",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294074616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BARRETT",
            "last_name": "WILLIS",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.