Kimberly D Willis, ACNP RN in Columbia, SC - Medicare Nurse Practitioner

Kimberly D Willis, ACNP RN is a medicare enrolled "Nurse Practitioner" in Columbia, South Carolina. Her current practice location is 166 Stoneridge Drive, Columbia, South Carolina. You can reach out to her office (for appointments etc.) via phone at (803) 461-3000.

Kimberly D Willis is licensed to practice in South Carolina (license number 2015) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1558496448.

Contact Information

	Kimberly D Willis, ACNP RN
	166 Stoneridge Drive, Columbia, SC 29210
	(803) 461-3000
	(803) 461-4903

Map and Direction

Provider's Profile

Full Name	Kimberly D Willis
Gender	Female
Speciality	Nurse Practitioner
Location	166 Stoneridge Drive, Columbia, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1558496448
Provider Enumeration Date: 02/22/2007
Last Update Date: 07/08/2016

Medicare PECOS Information:

PECOS PAC ID: 7214916212
Enrollment ID: I20040714000993

Medical Identifiers

Medical identifiers for Kimberly D Willis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1558496448	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	2015 (South Carolina)	Primary

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. Kimberly D Willis allows following entities to bill medicare on her behalf.

Entity Name	South Carolina Oncology Assoc Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1467406918 PECOS PAC ID: 6103739024 Enrollment ID: O20031107000064

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. Kimberly D 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
Kimberly D Willis, ACNP RN 166 Stoneridge Drive, Columbia, SC 29210 Ph: (803) 461-3000	Kimberly D Willis, ACNP RN 166 Stoneridge Drive, Columbia, SC 29210 Ph: (803) 461-3000

Reviews and Comments

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Kimberly D Willis, ACNP RN - Medicare Nurse Practitioner in Columbia, SC