Jennifer S Wilder, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101231146 Issued in VA

Practice address

20905 Professional PLZ
Ste 330
Ashburn, VA 20147-7783

Phone

(703) 726-0003

Fax

(703) 726-6444

NPI assigned

Aug 30, 2005

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 2

Other names 1

• Jennifer Slack Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Georgetown University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fairfax Family Practice Centers PCGroup PAC ID 4082513031, 106 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Inova Home Health LLC Home health agency, Fairfax, VA, CCN 497008
• Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Fairfax Family Practice Centers PC

  • Family Medicine Physician
  • Herndon, VA
  • NPI 1205944964
  Medicare reassignment Care Compare group
• Inova Physician Partners, LLC

  • Family Medicine Physician
  • Chantilly, VA
  • NPI 1215264916
  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  Family Medicine

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Inova Physician Partners, Inc. - Specialists

  • Orthopaedic Surgery Physician
  • Leesburg, VA
  • NPI 1811204050
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Alternate Solutions Home Health, LLC

  • Home Health Agency
  • Fairfax, VA
  • NPI 1710473673
  Care Compare affiliation
• Inova Health Care Services

  • Psychiatric Hospital Unit
  • Leesburg, VA
  • NPI 1285786228
  Care Compare affiliation
• Inova Health Care Services

  • General Acute Care Hospital
  • Leesburg, VA
  • NPI 1376564302
  Care Compare affiliation

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1710970355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791128",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212791128",
            "telephone_number": "703-726-0003",
            "fax_number": "703-726-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20905 PROFESSIONAL PLZ",
            "address_2": "STE 330",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201477783",
            "telephone_number": "703-726-0003",
            "fax_number": "703-726-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101231146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05647118",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00009757",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilder708322@soc.inova.org",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "affiliationName": "Inova Physician Partners, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "22895 Brambleton Plz Ste 200",
            "city": "Brambleton",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201484878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SLACK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Whitehead, COUNSELING
• Whole Child Pediatrics
• Hetti Thantrige Hiruni Wathsala Wickramasinghe, M.D.
• John C Wiger, DDS MS
• Brett Michael Wigley, BCBA
• Kristin Willert, PSYD
• Amanda Joslin Williams, PH.D.
• Benjamin D. Williams, PH.D.
• Brittany La'Trell Williams
• Charlie Vee Williams, LPC

• Family Medicine Physician in Ashburn, VA
• Providers in Ashburn, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.