Brandon James Wilmot, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1221008

Practice address

200 Mercy Circle
Camp Pendleton, CA 92055-5191

Phone

(760) 725-1288

NPI assigned

Nov 7, 2022

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• United States Navy

  • Military Hospital
  • San Diego, CA
  • NPI 1003226309
  NPD (past)

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1346958501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MERCY CIR",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-725-1288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34101 Farenholt Ave Bldg 14",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921347000",
            "country_code": "US",
            "telephone_number": "619-532-7968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILMOT",
        "first_name": "BRANDON",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-07",
        "last_updated": "2024-08-01",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1221008",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Clifford Willett, M.D.
• Stephen Craig Williams, PA-C
• Virginia Santiago Williams, PROPHY TECH
• John Williamson, MD
• Emanuel Vance Willis, DMD
• Justin Andrew Wilson, SOIDC
• Kevin Donald Wilson, DPT
• Paul Wilson, NP
• Zachary Dewitt Wilson, IDC
• Erin Wippermann, PT, DPT, OCS, CSCS

• All providers in Camp Pendleton, CA
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.