Jennifer L. Williams, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

213 Issued in WY

Practice address

201 Yellowstone Ave
Cody, WY 82414-9313

Phone

(307) 527-7561

NPI assigned

Nov 5, 2006

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 3

Medicare fee-for-service enrollment

Enrolled in WY, MT2 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

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rocky Mountain Vein Clinic PCGroup PAC ID 7113930025, 5 clinicians

William H and Carrie Gottsche FoundationGroup PAC ID 5092606293, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cody Regional Health Hospital, Cody, WY, CCN 531312

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Rocky Mountain Vein Clinic, P.C.

  • Vascular Surgery Physician
  • Cody, WY
  • NPI 1326089137

  MT

  Medicare reassignment Care Compare group
• Rocky Mountain Vein Clinic Great Falls Inc

  • Surgery Physician
  • Great Falls, MT
  • NPI 1528413093
  Medicare reassignment
• William H and Carrie Gottsche Foundation

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Thermopolis, WY
  • NPI 1558319392
  Care Compare group

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

• Cody Regional Health EMS

  • Land Ambulance
  • Cody, WY
  • NPI 1366432197

  Hospital

  Care Compare affiliation
• West Park Hospital District

  • Critical Access Hospital
  • Cody, WY
  • NPI 1558351536
  Care Compare affiliation

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

{
    "created_epoch": "1162684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1679652010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W YELLOWSTONE AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824148723",
            "telephone_number": "307-527-7129",
            "fax_number": "307-587-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 YELLOWSTONE AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824149313",
            "telephone_number": "307-527-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-05",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "314481",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WY MDCD PIN",
            "identifier": "108527100",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE PIN",
            "identifier": "925161030924",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sally J Whitman, PA-C
• Wild Roots Counseling LLC
• Derek Paul Wille, MD
• William H. and Carrie Gottsche Foundation
• Brandon Williams
• Lisa Williams, M.D.
• Stephanie McKinney Williams
• Wendy Marie Willis, RN, APRN
• Nancy Winkler, FNP
• Jay A Winzenried, M.D.

• Physician Assistant in Cody, WY
• Providers in Cody, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.