Peter Willis, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

10002005 Issued in OR

Practice address

2474 SW Perkins Ave
Pendleton, OR 97801-4302

Phone

(541) 966-6638

Fax

(541) 276-6327

NPI assigned

Jan 5, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Anthony Hospital Hospital, Pendleton, OR, CCN 381319

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Praxis Health, PC

  • Multi-Specialty Clinic/Center
  • Bend, OR
  • NPI 1821068164
  Medicare reassignment Care Compare group NPD
• Praxis Health, PC

  • Rural Health Clinic/Center
  • Dallas, OR
  • NPI 1942925326
  NPD

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

• Commonspirit Oregon

  • Critical Access Hospital
  • Pendleton, OR
  • NPI 1649276734
  Care Compare affiliation

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1477266385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2474 SW PERKINS AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978014302",
            "telephone_number": "541-966-6638",
            "fax_number": "541-276-6327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "PETER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10002005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Wilbur
• Dan E Wilcox Jr., M.A.
• Tania Carola Wildbill, M.S.
• Stephanie M Williams
• Joanita Glavel Williamson
• Willowbrook SNF Healthcare LLC
• Jennifer Lee Wilson, CD
• Julie Ann Wilson
• Kristina Lynn Wilson
• Paige Louise Wilson

• Nurse Practitioner in Pendleton, OR
• Providers in Pendleton, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.