Individual provider Active NPI

Jennifer L Naylor, PAC

  • Physician Assistant
  • Johnstown, PA
National Provider Identifier
1316903487
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA052132 Issued in PA
Practice address
429 Industrial Park Rd
Johnstown, PA 15904-1943
Phone
(814) 262-1219
NPI assigned
Apr 26, 2006
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA052132 PA Primary
Physician Assistant 363A00000X 0110002153 VA
Medical Physician Assistant 363AM0700X MA052132 PA

Addresses

Primary practice location

429 Industrial Park Rd
Johnstown, PA 15904-1943

Mailing address

429 Industrial Park Rd
Johnstown, PA 15904-1943
Phone (814) 262-1219

Other practice location 1

411 Theatre Dr
Johnstown, PA 15904-2838
Phone (814) 266-3934

Other identifiers 3

IdentifierTypeStateIssuer
P00337237OtherVAMEDICARE RAILROAD
1037413940001MedicaidPA
010232970MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA052132PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients
Pinnacle Treatment Centers PA-III, LLC PastSince May 1, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1316903487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 INDUSTRIAL PARK RD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159041943",
            "telephone_number": "814-262-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 INDUSTRIAL PARK RD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159041943",
            "telephone_number": "814-262-1219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Theatre Dr",
            "address_purpose": "LOCATION",
            "city": "Johnstown",
            "state": "PA",
            "postal_code": "159042838",
            "country_code": "US",
            "telephone_number": "814-266-3934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAYLOR",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052132",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002153",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA052132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00337237",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1037413940001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010232970",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.