Edie Willis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA62067 Issued in CA

Practice address

1520 San Pablo St Ste 1000
Los Angeles, CA 90033-5312

Phone

(323) 442-5100

NPI assigned

May 11, 2017

Sex

Female

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 GA, SC, CA, CO4 enrollments

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 4

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nephrology and Hypertension Medical Associates PCGroup PAC ID 0244227130, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036
• Effingham Health System Hospital, Springfield, GA, CCN 111306

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Nephrology and Hypertension Medical Associates PC

  • Nephrology Physician
  • Savannah, GA
  • NPI 1275553489
  Medicare reassignment Care Compare group NPD
• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306
  Medicare reassignment NPD
• Nephrology and Hypertension Medical Associates PC

  • Specialist
  • Okatie, SC
  • NPI 1184955791
  Medicare reassignment NPD
• Cedar Springs Hospitalist Medical Group, Inc.

  • Hospitalist Physician
  • Glendale, CA
  • NPI 1245799279
  Medicare reassignment
• Usc Care Medical Non-Contracted LLC

  • Nephrology Physician
  • Los Angeles, CA
  • NPI 1659509206
  Medicare reassignment
• Usc Care Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD
• Marshes Medical Diagnostic Clinic, PC

  • Nephrology Physician
  • Brunswick, GA
  • NPI 1013922699
  NPD
• Nephrology and Hypertension Medical Associates PC

  • Specialist
  • Jesup, GA
  • NPI 1730663857
  NPD
• Archbold Medical Group, Inc.

  • Surgery Physician
  • Thomasville, GA
  • NPI 1831353036
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)
• Nephrology Medical Associates of Georgia, LLC

  • Nephrology Physician
  • Fredericksburg, VA
  • NPI 1114344926
  NPD (past)

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

• Effingham Hospital, Inc.

  • Critical Access Hospital
  • Springfield, GA
  • NPI 1811962756
  Care Compare affiliation
• Savannah Health Services, LLC

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1053824292
  Care Compare affiliation

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1356877328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST STE 1000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335312",
            "telephone_number": "323-442-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "EDIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "008351",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA62067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precious N Willie
• Trisha Willie, OT
• Christine Michelle Willinger, MD, MPH
• Angela L Willis
• Angelica Z Willis
• Jakira Willis, LCSW, PPSC
• Kimberly Willis
• Lisa Willis
• Lori M Willis, PH.D.
• Monique Shanae Willis

• Medical Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.