Individual provider Active NPI

Jamie Lynn Whitesell

  • Physician Assistant
  • Broomall, PA
National Provider Identifier
1336690163
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA060058 Issued in PA
Practice address
2208 Sproul Rd
Broomall, PA 19008-2252
Phone
(610) 888-9446
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 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 OA004590 PA
Student in an Organized Health Care Education/Training Program 390200000X
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X MA060058 PA Primary

Addresses

Primary practice location

2208 Sproul Rd
Broomall, PA 19008-2252

Mailing address

2208 Sproul Rd
Broomall, PA 19008-2252
Phone (610) 888-9446

Other practice location 1

1528 Walnut St Ste 950
Philadelphia, PA 19102-3628
Phone (267) 273-1196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181109001736 NJ Practitioner - Physician Assistant 8426302423 Reassigns benefits to 1 organization
I20200928000709 PA Practitioner - Physician Assistant 8426302423 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Practice addresses (Care Compare)

1528 Walnut St
Suite 950
Philadelphia, PA 19102-3628
Phone (856) 872-7055

Hospital & facility affiliations

  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA004590PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC Single Specialty CurrentSince Sep 15, 2023 Accepting new patients
Advocare , LLC Single Specialty CurrentSince Sep 15, 2023 Accepting new patients
Advocare, LLC Single Specialty Past Accepting new patients
On Demand Urgent Care Group PC Past Accepting new patients

Locations

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

1100 Horizon Cir
Ste 101
Chalfont, PA 18914
Phone (215) 394-0400

216 Mall Blvd
Ste 200
King of Prussia, PA 19406
Phone (267) 273-1196

1528 Walnut St
Ste 950
Philadelphia, PA 19102
Phone (215) 600-4970

Interoperability endpoints

  • Direct secure messaging: jamie.whitesell@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1336690163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 SPROUL RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190082252",
            "telephone_number": "610-888-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 SPROUL RD",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190082252",
            "telephone_number": "610-888-9446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1528 Walnut St Ste 950",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191023628",
            "country_code": "US",
            "telephone_number": "267-273-1196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITESELL",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004590",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

Verify at the official NPI Registry.