Jennifer Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60554438 Issued in WA

Practice address

4111 194TH St SW
Lynnwood, WA 98036-4604

Phone

(425) 835-5200

NPI assigned

Jul 8, 2015

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 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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Olympic Healthcare NetworkGroup PAC ID 3779895396, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Olympic Medical Home Health Home health agency, Port Angeles, WA, CCN 507072
• Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072
• Forks Community Hospital Hospital, Forks, WA, CCN 501325
• St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwilson1140291@wm.providencedirect.org

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.

• North Olympic Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Port Angeles, WA
  • NPI 1154702264
  Medicare reassignment Care Compare group NPD
• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1730136367
  Medicare reassignment NPD
• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1023830346
  NPD
• North Olympic Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Port Angeles, WA
  • NPI 1639036924
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Clallam County Public Hospital District 2

  • General Acute Care Hospital
  • Port Angeles, WA
  • NPI 1306845557
  Care Compare affiliation
• Clallam County Public Hospital District 2

  • Home Health Agency
  • Port Angeles, WA
  • NPI 1437259165
  Care Compare affiliation
• Clallam County Public Hospital District No 1

  • Critical Access Hospital
  • Forks, WA
  • NPI 1891879680
  Care Compare affiliation
• Commonspirit Washington Community Care

  • General Acute Care Hospital
  • Silverdale, WA
  • NPI 1518912609
  Care Compare affiliation

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1174906176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 194TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 194TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364604",
            "telephone_number": "425-835-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60554438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Williamson
• Lee John Wilner Jr., LHMC
• Caitlin Anne Wilson, M.ED., BCBA, LBA
• Casey Valentine Wilson
• Cindy Lisa Wilson, RN
• Lindsey L Wilson, LMHC, NCC
• Mark Aaron Wilson, MD
• Michelle Lyn Wilson, LMT
• Pilar Wilson, OTR
• Reginald Wendell Wilson, M.D.

• Physician Assistant in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.