Roger Cecil Willis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD26451 Issued in OR

Practice address

790 E 5TH St
Coquille, OR 97423-1755

Phone

(541) 396-7295

NPI assigned

May 5, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

University of Arizona College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coquille Valley Hospital DistrictGroup PAC ID 6901714591, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oregon Coast Home Health Home health agency, Coos Bay, OR, CCN 387039
• Pacific Home Health and Hospice Home health agency, Coos Bay, OR, CCN 387135
• South Coast Hospice Hospice, Coos Bay, OR, CCN 381530
• Coquille Valley Hospital Hospital, Coquille, OR, CCN 381312
• Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090
• Southern Coos Hospital & Health Center Hospital, Bandon, OR, CCN 381304

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/5c5c3b5c-6128-40bc-b71b-102ccb82d7e7/

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.

• Coquille Valley Hospital District

  • Critical Access Hospital
  • Coquille, OR
  • NPI 1730223967
  Medicare reassignment Care Compare group NPD
• North Bend Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Coos Bay, OR
  • NPI 1407812365
  Medicare reassignment NPD
• Coquille Valley Hospital District

  • Medicare Defined Swing Bed Hospital Unit
  • Coquille, OR
  • NPI 1164557179
  NPD
• DHHS IHS Phoenix Area

  • Critical Access Hospital
  • Polacca, AZ
  • NPI 1356628028

  Family Medicine

  NPD (past)
• DHHS IHS Phoenix Area

  • Clinic/Center
  • Cibecue, AZ
  • NPI 1427335181
  NPD (past)

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

• Bay Area Home Health Operations LLC

  • Home Health Agency
  • Coos Bay, OR
  • NPI 1134801806
  Care Compare affiliation
• Bay Area Hospital District

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Care Compare affiliation
• Coquille Valley Hospital District

  • Critical Access Hospital
  • Coquille, OR
  • NPI 1730223967
  Care Compare affiliation
• Pacific Home Care Associates Inc.

  • Home Health Agency
  • Coos Bay, OR
  • NPI 1851350086
  Care Compare affiliation
• South Coast Hospice & Palliative Care Services Inc

  • Community Based Hospice Care Agency
  • Coos Bay, OR
  • NPI 1417956558
  Care Compare affiliation
• Southern Coos Health District

  • Critical Access Hospital
  • Bandon, OR
  • NPI 1588684484
  Care Compare affiliation

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1477501815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202099",
            "telephone_number": "541-267-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 E 5TH ST",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "974231755",
            "telephone_number": "541-396-7295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ROGER",
        "middle_name": "CECIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD26451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165031",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Dee St. Clair, LMT
• Strengths Based Explorations LLC
• Caterina Tadlock, QMHP
• Pauletta J Tokich, ARNP, FNP
• Shane Weare, D.O.
• Christina Lucile Wilson, MD

• Family Medicine Physician in Coquille, OR
• Providers in Coquille, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.