Kayla Marie Demus Wilmot, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9113901 Issued in FL

Practice address

1215 Dunn Ave Ste 1
Jacksonville, FL 32218-4897

Phone

(904) 745-3618

NPI assigned

Aug 19, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Kayla Marie Demus Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Care Partners Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1386147882
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1003428111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 FORT CAROLINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772044",
            "telephone_number": "904-745-3618",
            "fax_number": "904-722-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 DUNN AVE STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184897",
            "telephone_number": "904-745-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMOT",
        "first_name": "KAYLA",
        "middle_name": "MARIE DEMUS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9113901",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "PA9113901",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9113901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "DEMUS",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gwendolyn Ong Wills, RPH
• Jordan Marie Wills
• Sofia Wills, MA
• Sarah Willson
• Terry Lucas Willson, ATC, CSCS
• Tania Anntoinette Wilson-Ocran
• Alyssa Wilson
• Andrea Nicole Wilson, CNP
• Andria Wilson, PT, DPT
• Andy Wilson, ARNP

• Medical Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.