Willow Bartholomew, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

59339 Issued in CA

Practice address

205 South St
Fort Bragg, CA 95437-5540

Phone

(707) 964-1251

Fax

(707) 961-2722

NPI assigned

May 11, 2020

Last updated

Jul 9, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Willow Hubbard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Merit-based Incentive Payment System (MIPS)

Final score

80.98 of 100Reported as group

Quality

73.31

Promoting interoperability

92

Improvement activities

40

Cost

62

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1225650450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 RHODODENDRON AVE",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "287112934",
            "telephone_number": "828-989-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SOUTH ST",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375540",
            "telephone_number": "707-964-1251",
            "fax_number": "707-961-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTHOLOMEW",
        "first_name": "WILLOW",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "59339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLOW",
            "last_name": "HUBBARD",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Waseem Rasem Bader
• Gregory Baer
• M. Lee Baker, DDS
• Genevieve Marilyn Banegas, LCSW, PPSC
• Nadine R. Barlow, PHARMD
• Kenneth Roger Baumgartner, DDS
• Carrie Becker Fishman
• Joseph Edward Beeney, PHD
• Jack Linn Bellah, MD
• Logan Christopher Bengston, LMFT

• Physician Assistant in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.