Jessica B Willert, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME118879 Issued in FL

Practice address

2120 E Johnson Ave
Suite 103
Pensacola, FL 32514-6036

Phone

(850) 494-3965

NPI assigned

Jan 17, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1689654626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 E JOHNSON AVE",
            "address_2": "SUITE 103",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146036",
            "telephone_number": "850-494-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 E JOHNSON AVE",
            "address_2": "SUITE 103",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146036",
            "telephone_number": "850-494-3965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLERT",
        "first_name": "JESSICA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME118879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalli Taylor-Suzanne Wilks, NP
• Marena Rae Willeford, DO
• Jennifer Dasso Willem, M.S.W.
• Madelynn Ann Willemstein, PA-C
• Bryce Lawrence Willen, D.O.
• William B Henghold MD PA
• William B Waters D.C.P.a.
• William Belk MD LLC
• William C. Wilson D.O. P.a.
• William Shanahan

• Pediatrics Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.