Individual provider Active NPI

Jessica Elizabeth Willard, HAS

  • Hearing Instrument Specialist
  • Medford, OR
National Provider Identifier
1467931873
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HAS-P-10247472 Issued in OR
Practice address
920 Town Centre Dr
Medford, OR 97504-6100
Phone
(541) 414-8488
Fax
(971) 925-4120
NPI assigned
Aug 8, 2018
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5055 OR
Hearing Instrument Specialist 237700000X HAS-P-10247472 OR Primary

Addresses

Primary practice location

920 Town Centre Dr
Medford, OR 97504-6100

Mailing address

363 Jans CT
Central Point, OR 97502-2529
Phone (541) 973-7214

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5055ORMDPhysical Therapist
HAS-P-10247472ORMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1467931873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 JANS CT",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975022529",
            "telephone_number": "541-973-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 TOWN CENTRE DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046100",
            "telephone_number": "541-414-8488",
            "fax_number": "971-925-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "credential": "HAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "5055",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "OR",
            "license": "HAS-P-10247472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

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