Katherine Marie Willis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA169484 Issued in OR

Practice address

3325 Pocahontas Rd
Baker City, OR 97814-1464

Phone

(541) 524-8000

Fax

(541) 524-7955

NPI assigned

Oct 5, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Icco LLCGroup PAC ID 1355406729, 133 clinicians

Bend Memorial Clinic PCGroup PAC ID 7214936533, 225 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwillis16365@directmsg.bmctotalcare.com
• Direct secure messaging: kwillis1511119@direct.lhs.org

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.

• Icco, LLC

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment Care Compare group NPD
• Bend Memorial Clinic PC

  • Family Medicine Physician
  • Bend, OR
  • NPI 1699827477
  Medicare reassignment Care Compare group
• Good Shepherd Health Care System

  • Critical Access Hospital
  • Hermiston, OR
  • NPI 1295789667
  Medicare reassignment NPD
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Medicare reassignment
• Bend Memorial Clinic PC

  • Clinical Medical Laboratory
  • Bend, OR
  • NPI 1972144913
  NPD
• St. Charles Health System, Inc.

  • Critical Access Hospital
  • Prineville, OR
  • NPI 1710160445
  NPD

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

• Cascade Healthcare Community Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1412467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1326441353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-302-9342",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 POCAHONTAS RD",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141464",
            "telephone_number": "541-524-8000",
            "fax_number": "541-524-7955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 NE Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016051",
            "country_code": "US",
            "telephone_number": "541-392-2811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 NE Neff Rd",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016015",
            "country_code": "US",
            "telephone_number": "541-706-6892",
            "fax_number": "541-706-6813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-05",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA169484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwillis16365@directmsg.bmctotalcare.com",
            "affiliation": "N",
            "address_1": "1501 NE Medical Center Dr",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Lynn Whipple, QMHP-R, Cadc II
• Robin J White, LCSW
• Steven Whitehead, MSW
• Kari Alita Williams, MOT
• Valerie Williams
• Andrea Clare Wilson
• John Gordon Wilson, L.D.
• Laurie J Wittich
• Brenon Witty
• Julie Veeann Witty

• Physician Assistant in Baker City, OR
• Providers in Baker City, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.