Jeromy Glenn Wilson, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-2560 Issued in CO

Practice address

3520 W 92ND Ave
Westminster, CO 80031-3303

Phone

(303) 429-6600

Fax

(303) 429-6601

NPI assigned

Jan 8, 2008

Last updated

Nov 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Rocky Mountain Primary Care , PCGroup PAC ID 3779471677, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeromy.wilson.1@15135.direct.athenahealth.com
• Direct secure messaging: jeromy.wilson.1@24476.direct.athenahealth.com

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

• Rocky Mountain Primary Care , PC

  • Family Medicine Physician
  • Westminster, CO
  • NPI 1215981634
  Medicare reassignment Care Compare group
• Potomac Square Family Medicine, LLC

  • Primary Care Clinic/Center
  • Colorado Springs, CO
  • NPI 1992446405
  NPD
• Rocky Mountain Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Colorado Springs, CO
  • NPI 1710628219
  NPD
• SCL Physicians - RMPC LLC

  dba RMPC - Arvada

  • Family Medicine Physician
  • Arvada, CO
  • NPI 1952910721
  NPD

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1033394150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6080 W 92ND AVE",
            "address_2": "SUITE 1000",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800312928",
            "telephone_number": "303-427-0796",
            "fax_number": "303-429-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 W 92ND AVE",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800313303",
            "telephone_number": "303-429-6600",
            "fax_number": "303-429-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JEROMY",
        "middle_name": "GLENN",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-08",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA-2560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1080625",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Kaiser Williamson, PT, DPT
• Adam Willis, DDS
• Willow Run Dental, P.C.
• Wilson Chiropractic and Wellness LLC
• Cynthia C Wilson
• Sarah Wilson, LCSW
• Stephanie Wilson, L.AC.
• Sarah Elizabeth Winbourn, M.D.
• Elizabeth Grace Wingate
• Lezah Winick

• Physician Assistant in Westminster, CO
• Providers in Westminster, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.

Verify at the official NPI Registry.