Jamila Lee Petterson, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

Trainee Health Clinic
1940 Carswell Ave BLDG. 7002
Jbsa Lackland,, TX 78236

Phone

(210) 471-9056

NPI assigned

Jan 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1205982337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TRAINEE HEALTH CLINIC",
            "address_2": "1940 CARSWELL AVE BLDG. 7002",
            "city": "JBSA LACKLAND,",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-471-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTERSON",
        "first_name": "JAMILA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://app.tolsecuremessaging.com/PatientPortal/#!/Home",
            "affiliation": "N",
            "endpointDescription": "TOL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Trainee Health clinic",
            "address_2": "1940 Carswell Ave Bldg. 7002",
            "city": "JBSA Lackland,",
            "state": "TX",
            "country_code": "US",
            "postal_code": "78236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannel Anyae Pegram, DO
• Daniel Alexander Perales, PHYSICIAN ASSISTANT
• Ismael Perez
• Mack Andelin Peterson, D.O.
• Kyle Petrey, DPT
• Emily Grace Philips, OTD, OTR/L
• James Richard Phillips, DPT
• Assia L Phoenix, APRN, FNP-C
• Charlene Rose Barrera Piad, BSN, RN
• Jeb S. Pickard, M.D.

• Physician Assistant in Jbsa Lackland,, TX
• Providers in Jbsa Lackland,, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.