Dr Kimberly Rachelle Willis, MD is a medicare enrolled "Hospitalist" physician in Pine Bluff, Arkansas. She went to University Central Del Caribe Escuela De Medicina and graduated in 2005 and has 19 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Southeast Arkansas Hospitalists Llp and her current practice location is
1600 W 40th Ave, Pine Bluff, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(870) 541-8767.
Dr Kimberly Rachelle Willis is licensed to practice in Arkansas (license number E-5445) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1487852562.
Physician's Profile
| Full Name | Dr Kimberly Rachelle Willis |
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| Gender | Female |
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| Speciality | Family Practice |
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| Experience | 19 Years |
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| Location | 1600 W 40th Ave, Pine Bluff, Arkansas |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Kimberly Rachelle Willis attended and graduated from University Central Del Caribe Escuela De Medicina in 2005
NPI Data:
- NPI Number: 1487852562
- Provider Enumeration Date: 07/10/2007
- Last Update Date: 07/10/2024
Medicare PECOS Information:
- PECOS PAC ID: 1759455389
- Enrollment ID: I20080731000039
Medical Identifiers
Medical identifiers for Dr Kimberly Rachelle Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1487852562 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | E-5445 (Arkansas) | Secondary |
| 207Q00000X | Family Medicine | 2009-01271 (North Carolina) | Secondary |
| 208M00000X | Hospitalist | 2009-01271 (North Carolina) | Secondary |
| 208M00000X | Hospitalist | E-5445 (Arkansas) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Southeast Arkansas Hospitalists Llp | 9537479605 | 12 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kimberly Rachelle Willis allows following entities to bill medicare on her behalf.
| Entity Name | Southeast Arkansas Hospitalists Llp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1912374018
PECOS PAC ID: 9537479605
Enrollment ID: O20151103000750 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kimberly Rachelle Willis is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Kimberly Rachelle Willis, MD
152 Aviary Ct,
Clayton, NC 27520-4054
Ph: (501) 733-8722 | Dr Kimberly Rachelle Willis, MD
1600 W 40th Ave,
Pine Bluff, AR 71603-6301
Ph: (870) 541-8767 |
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