NPIMap

Individual provider Active NPI

Jason Robert Myrick, PA-C

  • Physician Assistant
  • Appleton, WI
National Provider Identifier
1487543997
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8504 Issued in WI
Practice address
1818 N Meade St
Appleton, WI 54911-3454
Phone
(920) 731-4101
NPI assigned
Jun 30, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8504 WI Primary

Addresses

Primary practice location

1818 N Meade St
Appleton, WI 54911-3454

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250910002010 WI Practitioner - Physician Assistant 4284137936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

1405 Mill St
New London, WI 54961-2155
Phone (920) 531-2000

1405 S Mill St
New London, WI 54961-2155
Phone (920) 831-5050

1818 N Meade St
Appleton, WI 54911-3454

1818 N Meade St Room
N255
Appleton, WI 54911-3454
Phone (920) 730-3383

225 Memorial Dr
Berlin, WI 54923-1243

333 N Green Bay Rd
Neenah, WI 54956-1954
Phone (920) 720-2300

4480 W Spencer St
Appleton, WI 54915
Phone (920) 738-4800

600 N Westhaven Dr
Oshkosh, WI 54904-6926
Phone (920) 725-0077

800 Riverside Dr
Waupaca, WI 54981-1943
Phone (715) 258-1000

900 E Grant St
Thedacare Orthopedic Care
Appleton, WI 54911-3454
Phone (920) 831-5050

N2934 State Rd
22 FL 1
Wautoma, WI 54982-5267
Phone (920) 361-6330

W5282 Amy Ave
Appleton, WI 54915-7233
Phone (920) 358-1900

Hospital & facility affiliations

  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160
  • Thedacare Medical Center-Waupaca Hospital, Waupaca, WI, CCN 521334
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Thedacare Medical Center - Shawano Hospital, Shawano, WI, CCN 521346

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8504WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Aug 25, 2025 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

250 W 6th Ave
Oshkosh, WI 54902
Phone (920) 237-5000

Organizations & group practices 2

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1487543997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-830-5900",
            "fax_number": "920-830-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 N MEADE ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113454",
            "telephone_number": "920-731-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRICK",
        "first_name": "JASON",
        "middle_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "8504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.