Philip Edward Willis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN.CRNA.06745 Issued in OH

Practice address

1805 27TH St
Portsmouth, OH 45662-2640

Phone

(740) 356-8231

Fax

(740) 356-3686

NPI assigned

Jan 23, 2006

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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Somc Medical Care Foundation, Inc.Group PAC ID 9436061645, 388 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southern Ohio Medical Center Hospital, Portsmouth, OH, CCN 360008

Merit-based Incentive Payment System (MIPS)

Final score

82.59 of 100Reported as group

Quality

59.57

Promoting interoperability

100

Improvement activities

40

Cost

71.16

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Somc Medical Care Foundation, Inc.

  • Family Medicine Physician
  • Portsmouth, OH
  • NPI 1457467227
  Medicare reassignment Care Compare group NPD
• Somc Medical Care Foundation, Inc.

  • Diagnostic Radiology Physician
  • Portsmouth, OH
  • NPI 1366686230
  NPD
• Somc Medical Care Foundation, Inc.

  • Anesthesiology Physician
  • Portsmouth, OH
  • NPI 1629247010

  Nurse Anesthetist, Certified Registered

  NPD
• Anesthesia Associates of Lima Inc

  • Certified Registered Nurse Anesthetist
  • Lima, OH
  • NPI 1487662300

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Chillicothe Anesthesia Associates Inc

  • Anesthesiology Physician
  • Chillicothe, OH
  • NPI 1902806789
  NPD (past)

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

• Southern Ohio Medical Center

  • General Acute Care Hospital
  • Portsmouth, OH
  • NPI 1053342816
  Care Compare affiliation

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1457331670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST STE B06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622681",
            "telephone_number": "740-356-6942",
            "fax_number": "740-356-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 27TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622640",
            "telephone_number": "740-356-8231",
            "fax_number": "740-356-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "PHILIP",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3117A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.06745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2213410",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74002312",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "philip.willis@somc.medicity.net",
            "affiliation": "N",
            "address_1": "1805 27th St",
            "city": "Portsmouth",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456622640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacey Williams, LPN
• Brittany Williamson
• Leeann Williamson, QMHS
• Cheryl Willis
• David William Willis, NP
• Alexandria Nichole Wilson, COTA/L
• Alva Justin Wilson
• Andrew Wilson
• Barbara Ann Wilson
• Cheryl K Wilson, CRNA

• Certified Registered Nurse Anesthetist in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Certified Registered Nurse Anesthetist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.