Jacob Ryan Stillwagon, RN, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP130118 Issued in TX

Practice address

1501 S Coulter St
Amarillo, TX 79106-1770

Phone

(806) 354-1000

NPI assigned

Jan 15, 2016

Last updated

Dec 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Em Alliance Texas PLLCGroup PAC ID 4587192430, 88 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Em Alliance Texas, PLLC

  • Emergency Medicine Physician
  • Amarillo, TX
  • NPI 1902621329
  Medicare reassignment Care Compare group NPD
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019

  Nurse Practitioner

  Medicare reassignment NPD
• Nes Southwest Medical Services Inc

  • Emergency Medicine Physician
  • Amarillo, TX
  • NPI 1093487449
  Medicare reassignment NPD
• Truepartners Northwest Emergency Associates PLLC

  • Emergency Medicine Physician
  • Amarillo, TX
  • NPI 1912447319
  Medicare reassignment NPD

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1083071468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7004 VOYAGER TRL",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791189122",
            "telephone_number": "806-898-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061770",
            "telephone_number": "806-354-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLWAGON",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "credential": "RN, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-15",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "803586",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130118",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "803586",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Laneigh Stewart, MD
• Jennifer Michelle Stewart, MA
• Joshua Stewart, DNP, CRNA
• Lois Ann Stickley, PT
• Cassidy Stiles
• Lindsey Nicole Stiner
• Brenda Nicole Stoddard, NP-C
• Raymond Dean Stoddard, LPC
• Elaina Stoker
• Susan E Stokes, LBSW

• Family Nurse Practitioner in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.