Jill S Vidrine, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.003323 Issued in OH

Practice address

536 S Trimble Rd
Mansfield, OH 44906-3418

Phone

(419) 756-8899

NPI assigned

Sep 22, 2011

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

Medicare fee-for-service enrollment

Enrolled in OH

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Spine Joint and Wellness CenterGroup PAC ID 6103066089, 4 clinicians

Practice addresses (Care Compare)

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.

• Advanced Spine Joint and Wellness Center

  • Family Medicine Physician
  • Medina, OH
  • NPI 1376881144
  Medicare reassignment Care Compare group
• North Central Ohio Family Care Center, Inc

  • Specialist
  • Galion, OH
  • NPI 1689822827
  Medicare reassignment
• Medcentral Professional Association Inc.

  • Anesthesiology Physician
  • Mansfield, OH
  • NPI 1306878863
  NPD (past)
• Medcentral Professional Foundation, LLC

  • Facial Plastic Surgery Physician
  • Mansfield, OH
  • NPI 1841476942
  NPD (past)

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1114200565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 S TRIMBLE RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 S TRIMBLE RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063418",
            "telephone_number": "419-756-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRINE",
        "first_name": "JILL",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Viaquest Healthcare Central
• Viaquest Healthcare Central
• Taylor Viars
• Michael R Viau, MD
• Victory Counseling Center, LLC
• Patrick Kyle Vidrine, P.A
• Timothy Louis Vierheller, D.C..
• Eric Michael Vikingstad, M.D.
• Amy Vincent, RN
• Visiting Nurse Association of Mid-Ohio

• Physician Assistant in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.