Jerriann Vigil, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0000939 Issued in CO

Practice address

100 W 4TH St
Walsenburg, CO 81089-1910

Phone

(719) 738-4590

NPI assigned

May 22, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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 1

Specialty

Physician Assistant

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pueblo Community Health Center Inc.Group PAC ID 4284543802, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jerriann.vigil.p1@direct.pueblochc.nextgenshare.com

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.

• Pueblo Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Pueblo, CO
  • NPI 1770529950
  Medicare reassignment Care Compare group
• Pueblo Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Pueblo, CO
  • NPI 1316466816
  NPD
• Pueblo Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Pueblo, CO
  • NPI 1952071219
  NPD

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1578720819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 76510",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809706510",
            "telephone_number": "719-859-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W 4TH ST",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810891910",
            "telephone_number": "719-738-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGIL",
        "first_name": "JERRIANN",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-22",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0000939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73802832",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Thibault-Lloyd, PT
• Barbara Jo Trujillo, RN
• Amy Nicole Vallejos, CCC-SLP
• Vigil Enterprises (Vigil Family Chiropractic)
• James Theodore Vigil, D.C.
• Sandeep Suresh Vijan, MD
• Solomon Villalon, M.D.
• Susan Kae Walker, NP
• Walsen Clinic
• Dana Walsh

• Physician Assistant in Walsenburg, CO
• Providers in Walsenburg, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.

Verify at the official NPI Registry.