Kerry Allen Willis, MD is a medicare enrolled "Family Medicine" physician in Beaufort, North Carolina. He went to University Of North Carolina At Chapel Hill School Of Medicine and graduated in 1985 and has 39 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Open Water Medical Pa and his current practice location is
1620 Live Oak St, Suite C, Beaufort, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(252) 728-5737.
Kerry Allen Willis is licensed to practice in North Carolina (license number 30580) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1831176072.
Physician's Profile
| Full Name | Kerry Allen Willis |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 39 Years |
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| Location | 1620 Live Oak St, Beaufort, North Carolina |
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| Accepts Medicare Assignments | Yes. He 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:
- Kerry Allen Willis attended and graduated from University Of North Carolina At Chapel Hill School Of Medicine in 1985
NPI Data:
- NPI Number: 1831176072
- Provider Enumeration Date: 12/29/2005
- Last Update Date: 12/03/2013
Medicare PECOS Information:
- PECOS PAC ID: 6406939891
- Enrollment ID: I20110105001046
Medical Identifiers
Medical identifiers for Kerry Allen Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831176072 | NPI | - | NPPES |
| 8988112 | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 30580 (North Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Open Water Medical Pa | 2961314315 | 8 |
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. Kerry Allen Willis allows following entities to bill medicare on his behalf.
| Entity Name | Open Water Medical Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750482493
PECOS PAC ID: 2961314315
Enrollment ID: O20031104000183 |
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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. Kerry Allen 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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Kerry Allen Willis, MD
1620 Live Oak St, Suite C,
Beaufort, NC 28516
Ph: (252) 728-5737 | Kerry Allen Willis, MD
1620 Live Oak St, Suite C,
Beaufort, NC 28516
Ph: (252) 728-5737 |
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