Physician Compare National (NPI:1215284096)

HEALTHCARE PROVIDER: HEATHER MARIE WILLIS MPAP, PA-C

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1215284096
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7618105206
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140103000830
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WILLIS
	Individual professional last name
Provider First Name	HEATHER MARIE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PRIMARY CARE PARTNERS - SLO, P.C.
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7113203647
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	84 SANTA ROSA ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A
	Group Practice or individual's line 2 address
City	SAN LUIS OBISPO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	934051812
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8055914727
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050232
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FRENCH HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050107
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MARIAN REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y