Active NPI
Jill M Wilkens, PA-C
- Physician Assistant
- Wadena, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10825
- Practice address
- 4 Deerwood Ave
Wadena, MN 56482 - Phone
- (218) 631-1360
- NPI assigned
- Jul 26, 2010
- Last updated
- Jun 7, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10825 | MN | Primary |
Addresses
Primary practice location
4 Deerwood Ave
Wadena, MN 56482
Mailing address
4 Deerwood Ave
Wadena Medical Center
Wadena, MN 56482
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457665986 | Other | MN | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4 Deerwood Ave NW
Wadena, MN 56482-1253
Phone (218) 631-1360
415 Jefferson St N
Wadena, MN 56482-1264
Phone (218) 631-7495
415 Jefferson St N
Wadena, MN 56482-1296
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10825 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Astera Health | Current | Accepting new patients | |
| Perham Hospital District | Current | Accepting new patients | |
| Perham Hospital District | Current | Accepting new patients | |
| Sibley Medical Center | Past | Accepting new patients | |
| Allina Health System | Past | Accepting new patients |
Locations
105 Otter Dr
Ottertail, MN 56571
Phone (218) 367-6111
1000 Coney St W
Perham, MN 56573
Phone (218) 347-1200
4 Deerwood Ave NW
Wadena, MN 56482
Phone (218) 631-1100
415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510
421 11th St NW
Wadena, MN 56482
Phone (218) 631-3510
Interoperability endpoints
- jwilkens25726@direct.centracare.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Durable Medical Equipment & Medical Supplies
- Perham, MN
- NPI 1558630012
-
dba Allina Health TeleRheumatology
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
-
dba Ridgeview Sibley Medical Center - Swing
- Medicare Defined Swing Bed Hospital Unit
- Arlington, MN
- NPI 1003876491
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Astera Health Ottertail Clinic
- Rural Health Clinic/Center
- Ottertail, MN
- NPI 1871546663
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307404800000",
"number": "1457665986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 DEERWOOD AVE",
"address_2": "WADENA MEDICAL CENTER",
"city": "WADENA",
"state": "MN",
"postal_code": "56482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 DEERWOOD AVE",
"city": "WADENA",
"state": "MN",
"postal_code": "56482",
"telephone_number": "218-631-1360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKENS",
"first_name": "JILL",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-26",
"last_updated": "2011-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "10825",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1457665986",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wadena, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.