Jillian Denice Calhoun, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10005299 Issued in WA

Practice address

1806 W Lincoln Ave
Yakima, WA 98902-2473

Phone

(509) 452-4520

Fax

(509) 452-5224

NPI assigned

Oct 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Jillian Denice Vetsch Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Kittitas Valley Urgent Care PLLCGroup PAC ID 5092093542, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Kittitas Valley Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Ellensburg, WA
  • NPI 1578926770

  WA

  Medicare reassignment Care Compare group NPD
• Kittitas Valley Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Union Gap, WA
  • NPI 1215567300
  Care Compare group
• Kittitas Valley Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Yakima, WA
  • NPI 1740906551
  Care Compare group

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1073702452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 5TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023550",
            "telephone_number": "509-494-6700",
            "fax_number": "509-573-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 W LINCOLN AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022473",
            "telephone_number": "509-452-4520",
            "fax_number": "509-452-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALHOUN",
        "first_name": "JILLIAN",
        "middle_name": "DENICE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0301849",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2011646",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0225792",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "VETSCH",
            "middle_name": "DENICE",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Fides Caliwag, MD
• Joanna Call
• Thaddaeus Micah Callaghan, DPT
• Citlalmina Caltenco

• All providers in Yakima, WA
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.