Individual provider Active NPI

Jennifer Anne Wann, PA

  • Physician Assistant
  • The Villages, FL
National Provider Identifier
1689753477
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1950 Laurel Manor Dr Ste 224
The Villages, FL 32162-5602
Phone
(352) 751-6565
NPI assigned
Nov 3, 2006
Last updated
Nov 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X FL Primary

Addresses

Primary practice location

1950 Laurel Manor Dr Ste 224
The Villages, FL 32162-5602

Mailing address

1950 Laurel Manor Dr Ste 224
The Villages, FL 32162-5602
Phone (352) 751-6565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20191115001917 FL Practitioner - Physician Assistant 6204109929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vizavee Urgent and Primary Care, LLCGroup PAC ID 1557764784, 15 clinicians

Practice addresses (Care Compare)

340 Heald Way
Suite 208
The Villages, FL 32163-6000
Phone (352) 399-7301

4669 E Sr
44 Suite 101
Wildwood, FL 34785-7460
Phone (352) 399-7301

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1689753477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 LAUREL MANOR DR STE 224",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625602",
            "telephone_number": "352-751-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 LAUREL MANOR DR STE 224",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625602",
            "telephone_number": "352-751-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANN",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.