Jessica Lane Gomillion, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9102830 Issued in FL

Practice address

2300 SE 17TH St
St 500
Ocala, FL 34471-9107

Phone

(352) 867-0444

Fax

(352) 867-5522

NPI assigned

Jul 26, 2006

Last updated

Feb 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jessica.gomillion.1@14883.direct.athenahealth.com
• Direct secure messaging: jessica.gomillion.2@14883.direct.athenahealth.com
• Direct secure messaging: jessica.gomillion@hca5.eclinicaldirectplus.com

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.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1548283799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 SE 17TH ST",
            "address_2": "ST 500",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344719107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SE 17TH ST",
            "address_2": "ST 500",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344719107",
            "telephone_number": "352-867-0444",
            "fax_number": "352-867-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMILLION",
        "first_name": "JESSICA",
        "middle_name": "LANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102830",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "PA9102830",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292525700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JESSICA.GOMILLION@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "2300 SE 17th St",
            "address_2": "ST 500",
            "city": "Ocala",
            "state": "FL",
            "country_code": "US",
            "postal_code": "344719107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Miguel Gomez Sosa, RBT
• Anderson Gomez-Herrera, COTA/L
• Annelise Gomez, RBT
• Cindy Gomez
• Pedro Gomez, M.A.
• Lynnette Gongora, RBT
• Bruce Allen Gonseth Sr., LMT
• Joellie Marie Gonseth, BS, LMT
• Dapne Gonzalez Marin, RBT
• Claudia Beatrice Gonzalez-Matos, M.D.

• Physician Assistant in Ocala, FL
• Providers in Ocala, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.