Miriam J Wilbon, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

A10315 Issued in LA

Practice address

3330 Masonic Dr
Alexandria, LA 71301-3841

Phone

(318) 487-1122

NPI assigned

Mar 20, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Merit-based Incentive Payment System (MIPS)

Final score

89.78 of 100Reported as group

Quality

77.82

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Foucher Emergency Group LLC

  • Emergency Medicine Physician
  • New Orleans, LA
  • NPI 1871879007
  Medicare reassignment
• Independence Emergency Group LLC

  • Emergency Medicine Physician
  • Metairie, LA
  • NPI 1528384773
  Medicare reassignment
• Kenner Emergency Group LLC

  • Emergency Medicine Physician
  • Kenner, LA
  • NPI 1013986546
  Medicare reassignment
• Lafourche Medical Group LLC

  • Urgent Care Clinic/Center
  • Raceland, LA
  • NPI 1164811790
  Medicare reassignment
• Louisiana State University School of Medicine in New Orleans Faculty

  • Emergency Medicine Physician
  • New Orleans, LA
  • NPI 1275984973
  Medicare reassignment
• St. John Emergency Group LLC

  • Emergency Medicine Physician
  • La Place, LA
  • NPI 1265401509
  Medicare reassignment
• Van Meter Emergency Physicians Inc. Apmc

  • Emergency Medicine Physician
  • Covington, LA
  • NPI 1649410697
  Medicare reassignment
• Louisiana Em-1 Medical Services, a Medical Corporation

  • Emergency Medicine Physician
  • Covington, LA
  • NPI 1770536658

  Physician Assistant

  NPD (past)
• Tchefuncta Emergency Physicians LLC

  • Emergency Medicine Physician
  • Covington, LA
  • NPI 1194890624

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1629249347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1502",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700691502",
            "telephone_number": "985-651-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 MASONIC DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013841",
            "telephone_number": "318-487-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBON",
        "first_name": "MIRIAM",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-20",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "LA",
            "license": "G02542",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "A10315",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "A10315",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "LA",
            "license": "A10315",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1886203",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chrishonda Marie Whitlock, PA-C
• Elizabeth Whitmore, RN
• Charles Rud Whittington, DC
• Sarah Ann Whittington, BSN, RN, CCRN
• Kai Alexandria Wicker Brown, MD
• Wildel, LLC
• Wildel, LLC
• Wildel, LLC
• Jeremy Matthew Wiley, MSN, APRN, FNP-C
• Hailee Cne Wilkins

• Medical Physician Assistant in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Medical Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.