Active NPI
Jennifer Cougill, PA-C
- Medical Physician Assistant
- Prescott, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5219
- Practice address
- 1003 Willow Creek Rd
Prescott, AZ 86301-1641 - Phone
- (602) 758-4343
- NPI assigned
- Sep 18, 2012
- Last updated
- Oct 17, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 116249 | IA | |
| Medical Physician Assistant | 363AM0700X | 5219 | AZ | Primary |
Addresses
Primary practice location
1003 Willow Creek Rd
Prescott, AZ 86301-1641
Mailing address
1003 Willow Creek Rd
Prescott, AZ 86301-1641
Phone (602) 758-4343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, NE, IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2510 Bellevue Medical Ctr Dr
Bellevue, NE 68123-1520
Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116249 | IA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Century Physicians of Nebraska LLC | Current | Accepting new patients | |
| Cep America - Arizona PC | Current | Accepting new patients | |
| Alegent Creighton Clinic | Physician Assistant | Current | Accepting new patients |
| Cep America- Arizona, PC | Current | Accepting new patients |
Locations
10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690
14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000
2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000
800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660
16901 Lakeside Hills Ct
Omaha, NE 68130
Phone (402) 572-6500
Interoperability endpoints
- jcougill418737@direct.nebraskamed.com
Organizations & group practices 7
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.
-
- Multi-Specialty Clinic/Center
- Omaha, NE
- NPI 1417912114
-
- Emergency Medicine Physician
- Chandler, AZ
- NPI 1780202804
-
dba CHI Health Clinic
- Family Medicine Physician
- Council Bluffs, IA
- NPI 1598811069
Physician Assistant
-
- Emergency Medicine Physician
- Prescott, AZ
- NPI 1508816257
-
- Emergency Medicine Physician
- Mesa, AZ
- NPI 1356021190
-
- Emergency Medicine Physician
- Papillion, NE
- NPI 1063411833
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Bellevue Medical Center - Nebraska Medicine
- General Acute Care Hospital
- Bellevue, NE
- NPI 1609007525
-
dba The Nebraska Medical Center - Nebraska Medicine
- General Acute Care Hospital
- Omaha, NE
- NPI 1356307581
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1518217447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1003 WILLOW CREEK RD",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011641",
"telephone_number": "602-758-4343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1003 WILLOW CREEK RD",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011641",
"telephone_number": "602-758-4343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUGILL",
"first_name": "JENNIFER",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-18",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "116249",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AZ",
"license": "5219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.