Jahmaal Jason Willis, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95024311 Issued in CA

Practice address

12740 Hesperia Rd Ste B
Victorville, CA 92395-8306

Phone

(760) 713-6969

NPI assigned

Mar 8, 2023

Last updated

Apr 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Razi Medical Group IncGroup PAC ID 1456580737, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valde Home Health, Inc Home health agency, Victorville, CA, CCN 053161

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EECJBD

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.

• Razi Medical Group Inc

  • Internal Medicine Physician
  • Victorville, CA
  • NPI 1295165645
  Medicare reassignment Care Compare group
• Wildwood Court LLC

  • Assisted Living Facility
  • Victorville, CA
  • NPI 1821820762
  NPD Authorized official
• Shima Hadidchi MD a Professional Corp

  • Family Medicine Physician
  • Victorville, CA
  • NPI 1225685332
  NPD

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

• Valde Home Health, Inc

  • Home Health Agency
  • Victorville, CA
  • NPI 1184073389
  Care Compare affiliation

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1679273551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12740 HESPERIA RD STE A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958306",
            "telephone_number": "760-713-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12740 HESPERIA RD STE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958306",
            "telephone_number": "760-713-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JAHMAAL",
        "middle_name": "JASON",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95024311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Traci R Williams, PT
• Wesley Wayne Williams
• Dashonne Williamsbenjamin
• Dianne Williamson, RPH
• Heaven Willis
• Jason A Willridge
• Kristina Wilmoth
• Elsie Wilridge
• Demetris Wilson
• Erica Wilson

• Family Nurse Practitioner in Victorville, CA
• Providers in Victorville, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.