Jessica Diane Womack, MPA, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA18577 Issued in TX

Practice address

1900 Mistletoe Blvd Ste 200
Fort Worth, TX 76104-4049

Phone

(817) 878-5333

Fax

(817) 878-5334

NPI assigned

Sep 25, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA, TX2 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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fort Worth Brain and Spine Institute, LLPGroup PAC ID 0840273868, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Fort Worth Hospital, Fort Worth, TX, CCN 450672
• Baylor Scott and White Surgical Hospital Fortworth Hospital, Fort Worth, TX, CCN 450880
• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1015.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: jwomack6974@direct.orthovirginia.com

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.

• Fort Worth Brain & Spine Institute, LLP

  • Neurological Surgery Physician
  • Fort Worth, TX
  • NPI 1770503237
  Medicare reassignment Care Compare group
• Orthovirginia Inc

  • Multi-Specialty Clinic/Center
  • Mechanicsville, VA
  • NPI 1487671822
  Medicare reassignment
• Orthovirginia, Inc

  • Physical Medicine & Rehabilitation Physician
  • Arlington, VA
  • NPI 1376411413
  NPD
• Orthovirginia, Inc.

  • Multi-Specialty Clinic/Center
  • Prince George, VA
  • NPI 1033548441

  Physician Assistant

  NPD
• One Hampton Medical, LLC

  • Emergency Medicine Physician
  • Mechanicsville, VA
  • NPI 1366888224

  Physician Assistant

  NPD (past)
• Tidewater Emergency Medical Care

  • Physician Assistant
  • Chesapeake, VA
  • NPI 1295366201
  NPD (past)

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

• Columbia Plaza Medical Center of Fort Worth Subsidiary LP

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1659323772
  Care Compare affiliation
• Fort Worth Surgicare Partners LTD

  • Special Hospital
  • Fort Worth, TX
  • NPI 1568883775
  Care Compare affiliation
• Fort Worth Surgicare Partners, LTD.

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1871599183
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation

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

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1700110582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 BOULDERS PKWY",
            "address_2": "SUITE 200",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232254067",
            "telephone_number": "804-560-5595",
            "fax_number": "804-560-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 MISTLETOE BLVD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044049",
            "telephone_number": "817-878-5333",
            "fax_number": "817-878-5334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13700 St Francis Blvd",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231143222",
            "country_code": "US",
            "telephone_number": "804-379-2414",
            "fax_number": "804-379-2413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "JESSICA",
        "middle_name": "DIANE",
        "name_prefix": "Miss",
        "credential": "MPA, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-25",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110003149",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA18577",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003149",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwomack6974@direct.orthovirginia.com",
            "affiliation": "N",
            "endpointDescription": "Dr. Womack direct address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "secure messaging",
            "address_1": "13700 St Francis Blvd",
            "address_2": "Suite 103",
            "city": "Midlothian",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231143222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Wolfshohl
• Christina Wolinski
• Caroline Wolov, PA-C
• Rebecca Neili Wolverton, FNP-C
• Elizabeth Womack
• Elizabeth Wombaker
• Christopher Chad Womble, DPT
• Eric Matthew Womboldt
• Suzanne Sophia Wombough, FNP-C
• Craig Mahlon Womeldorph, DO

• Surgical Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.