NPIMap

Individual provider Active NPI

Jamie Lea Taylor Bell, PA-C

  • Physician Assistant
  • Hayward, WI
National Provider Identifier
1609986280
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1334-023 Issued in WI
Practice address
11134 N State Road 77
Hayward, WI 54843-5325
Phone
(715) 634-5505
Fax
(715) 634-5558
NPI assigned
Aug 30, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1334 WI
Physician Assistant 363A00000X 1334-023 WI Primary

Addresses

Primary practice location

11134 N State Road 77
Hayward, WI 54843-5325

Mailing address

105 4TH Ave
PO Box 336
Shell Lake, WI 54871-0336
Phone (715) 468-2711

Other practice location 1

105 4th Ave
Shell Lake, WI 54871-0336
Phone (715) 468-2711

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
I20070727000242 WI Practitioner - Physician Assistant 0941301493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians
St Marys Hospital of SuperiorGroup PAC ID 8628964228, 96 clinicians

Practice addresses (Care Compare)

10405 Vermont Ave
Hayward, WI 54843-6111
Phone (715) 699-1355

11134 N State Rd
Suite 77
Hayward, WI 54843-5325
Phone (715) 634-5505

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1334WIMDPhysician Assistant
1334-023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Hospital of Superior CurrentSince Jun 26, 2017 Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
St. Mary's Hospital of Superior CurrentSince Jun 26, 2017 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

11134 N State Road 77
Hayward, WI 54843
Phone (715) 634-5505

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

3500 Tower Ave
Ste 1
Superior, WI 54880
Phone (715) 395-5457

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1609986280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 4TH AVE",
            "address_2": "PO BOX 336",
            "city": "SHELL LAKE",
            "state": "WI",
            "postal_code": "548710336",
            "telephone_number": "715-468-2711",
            "fax_number": "715-468-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11134 N STATE ROAD 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548435325",
            "telephone_number": "715-634-5505",
            "fax_number": "715-634-5558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Shell Lake",
            "state": "WI",
            "postal_code": "548710336",
            "country_code": "US",
            "telephone_number": "715-468-2711",
            "fax_number": "715-468-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELL",
        "first_name": "JAMIE LEA",
        "middle_name": "TAYLOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1334",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1334-023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, WI

Sources for this page

Verify at the official NPI Registry.