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MS. KONNEEN WILLIS PA
NPI 1861510240
Physician Assistant - Medical in Bountiful, UT

Active since March 26, 2007PECOS EnrolledAccepts Medicare Assignment
21.6/100
CMS Quality Rating
1551 RENAISSANCE TOWNE DR, STE 460, BOUNTIFUL, UT 84010(801) 294-7246(801) 294-2560 Get Directions Write a Review

NPPES record last updated: February 25, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Konneen Willis Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KONNEEN WILLIS PA (NPI 1861510240) is an individual medical provider in Bountiful, Utah, licensed in Utah (107354-1206) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1861510240
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMS. KONNEEN WILLISCredential: PA
Location Address1551 RENAISSANCE TOWNE DR, STE 460Bountiful, UT 84010-7667
Mailing Address1551 Renaissance Towne Dr, Ste 540Bountiful, UT 84010-7678 · (801) 408-7660 · Fax (801) 408-7650
Phone(801) 294-7246
Fax(801) 294-2560
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateMarch 26, 2007
Last NPPES UpdateFebruary 25, 2021
NPPES CertifiedFebruary 25, 2021
✔ NPI 1861510240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in UT · 107354-1206
1551 RENAISSANCE TOWNE DR, Bountiful, UT 84010
Open in Google Maps ↗

Other Identifiers 1

Medicaid1861510240UT

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Konneen Willis Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4587765813
PECOS Enrollment IDI20070731000062
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
209 services174 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
45 services25 patients
Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
27 services20 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

21.6/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality13.01
Improvement Activities0
Cost54.65

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JILL FREITAS CALDERWOOD AU.D.
Audiologist
1551 RENAISSANCE TOWNE DR
BOUNTIFUL, UT 84010
Davis County (801) 295-5581
COMPREHENSIVE IMAGING SERVICES LLC
Radiology (Diagnostic Radiology)
1551 RENAISSANCE TOWNE DR
BOUNTIFUL, UT 84010
Davis County (801) 298-7272
BRANDI MARIE HARRIS
Physician Assistant
1551 RENAISSANCE TOWNE DR
BOUNTIFUL, UT 84010
Davis County (801) 295-7200
JORDAN SCOTT CARVER PHARMD
Pharmacist
1551 RENAISSANCE TOWNE DR, #104
BOUNTIFUL, UT 84010
Davis County (801) 295-6979
DR. MARK L NELSON D.D.S
Dentist (Pediatric Dentistry)
1551 RENAISSANCE TOWNE DR, SUITE 540
BOUNTIFUL, UT 84010
Davis County (801) 295-8322
CHILDREN'S DENTISTRY
Dentist (Pediatric Dentistry)
1551 RENAISSANCE TOWNE DR, STE 540
BOUNTIFUL, UT 84010
Davis County (801) 295-8322
CURT ROBERT STOCK M.D.
Otolaryngology
1551 RENAISSANCE TOWNE DR, SUITE 310
BOUNTIFUL, UT 84010
Davis County (801) 295-5581
JARED J TYSON MD PC
Specialist
1551 RENAISSANCE TOWNE DR, SUITE 400
BOUNTIFUL, UT 84010
Davis County (801) 295-7200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Konneen Willis's NPI number?

The NPI number for Konneen Willis is 1861510240. It was assigned to this individual provider in the NPPES registry on March 26, 2007.

Where is Konneen Willis located?

Konneen Willis practices at 1551 Renaissance Towne Dr Ste 460, Bountiful, UT 84010. The listed phone number is (801) 294-7246.

What is Konneen Willis's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Konneen Willis enrolled in Medicare?

Yes. Konneen Willis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Konneen Willis was last updated on February 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.