Active NPI
Jonathan Wilford, DO
- Family Medicine Physician
- Quincy, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036134782
- Practice address
- 927 Broadway St
Suite 121
Quincy, IL 62301-2719 - Phone
- (217) 224-6423
- Fax
- (217) 277-5960
- NPI assigned
- Jun 24, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | O-1414 | ID | |
| Family Medicine Physician | 207Q00000X | 036134782 | IL | Primary |
Addresses
Primary practice location
927 Broadway St
Suite 121
Quincy, IL 62301-2719
Mailing address
927 Broadway St
Quincy, IL 62301-2719
Phone (217) 224-6423
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036134782 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Touro Un College of Osteopathic Medicine, Vallejo, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2305 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-1764
2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700
2330 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234
2351 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 522-7310
2353 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-4823
2375 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 552-1234
2725 Channing Way
Idaho Falls, ID 83404-7510
Phone (208) 525-8448
Hospital & facility affiliations
- Aspen Home Health Services
- Mountain View Hospital
- Idaho Falls Community Hospital, LLC
- Eastern Idaho Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O-1414 | ID | MD | Family Medicine Physician |
| 036134782 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care | Family Medicine | Current | Accepting new patients |
| Teton Valley Health Care Inc | Family Medicine | Current | Accepting new patients |
| Mountain View Hospital LLC | Current | Accepting new patients | |
| Community Care West Side LLC | Family Medicine | Current | Accepting new patients |
| Teton Valley Health Care Inc | Family Medicine | Current | Accepting new patients |
| Teton Valley Health Care, Inc | Current | Accepting new patients | |
| Mountain View Hospital Physician Organization | Past | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
283 N 1st St
Driggs, ID 83422
Phone (208) 354-2302
120 E Howard St
Driggs, ID 83422
Phone (208) 354-2302
2730 Channing Way
Idaho Falls, ID 83404
Phone (208) 542-7100
2725 Channing Way
Idaho Falls, ID 83404
Phone (208) 525-8448
2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686
765 S Utah Ave
Idaho Falls, ID 83402
Phone (208) 525-2600
404 N 2nd E
Rexburg, ID 83440
Phone (208) 359-1770
167 E 1st S
Rigby, ID 83442
Phone (208) 745-8747
Organizations & group practices 8
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.
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1669462362
-
- Family Medicine Physician
- Idaho Falls, ID
- NPI 1295009785
-
- Family Medicine Physician
- Idaho Falls, ID
- NPI 1790708832
-
- Family Medicine Physician
- Driggs, ID
- NPI 1316294531
-
- Medicare Defined Swing Bed Hospital Unit
- Driggs, ID
- NPI 1053669598
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1073834529
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1225082209
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1114481447
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1669462362
-
- Home Health Agency
- Idaho Falls, ID
- NPI 1083760185
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672272000000",
"number": "1013203314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "927 BROADWAY ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623012719",
"telephone_number": "217-224-6423",
"fax_number": "217-228-3251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "927 BROADWAY ST",
"address_2": "SUITE 121",
"city": "QUINCY",
"state": "IL",
"postal_code": "623012719",
"telephone_number": "217-224-6423",
"fax_number": "217-277-5960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILFORD",
"first_name": "JONATHAN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-24",
"last_updated": "2022-12-29",
"certification_date": "2022-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "O-1414",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036134782",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036134782",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.1068.1",
"affiliationName": "Cobius Healthcare Solutions",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "2720 Dundee Rd # 302",
"city": "Northbrook",
"state": "IL",
"country_code": "US",
"postal_code": "600622609",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.