Jill Marie Wortham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01852 Issued in TX

Practice address

6210 S. Broadway
Tyler, TX 75703

Phone

(800) 893-9698

NPI assigned

Jul 3, 2006

Last updated

Dec 22, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Spine and Joint Hospital LLCGroup PAC ID 0345272381, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Texas Spine and Joint Hospital, LLC

  dba Baylor Scott & White TX Spine & Joint Hos Imaging Ctr

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1942292255
  Medicare reassignment Care Compare group
• Camino Real Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Livingston, TX
  • NPI 1992871966
  NPD (past)
• Texas Emergency Room Services PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1992843387
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1346279031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 CHURCHILL DR",
            "address_2": "SUITE 201",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034556",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6210 S. BROADWAY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "800-893-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHAM",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "PA01852",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakimberely Shajuan Wooten, APRN
• Maria De Jesus Wooten
• Marcus William Worden, DDS
• Sydney Worth
• James E Wortham, P.A.
• Thomas Mason Worthington Jr., M.D.
• Kathryn Wortz, PHD
• Dallas Wright, D.O.
• Erica Wright
• James Keith Wright, LPC

• Physician Assistant in Tyler, TX
• Providers in Tyler, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.