Jennifer Reeves Willard, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

102881 Issued in NC

Practice address

301 E Wendover Ave Ste 200
Greensboro, NC 27401-1232

Phone

(336) 482-2309

Fax

(336) 268-3157

NPI assigned

Dec 13, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagle Physicians and Associates PAGroup PAC ID 0244134468, 101 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.willard@eaglep.eclinicaldirectplus.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.

• Eagle Physicians and Associates PA

  • Sleep Medicine (Internal Medicine) Physician
  • Greensboro, NC
  • NPI 1609070648

  NC

  Medicare reassignment Care Compare group NPD
• Eagle Physicians and Associates PA

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1457436982

  NC

  Medicare reassignment Care Compare group
• Eagle Physicians and Associates PA

  • Ambulatory Surgical Clinic/Center
  • Greensboro, NC
  • NPI 1396852570
  Care Compare group NPD (past)
• Eagle Physicians and Associates PA

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1457423907
  NPD
• Eagle Physicians and Associates PA

  • Physical Therapist
  • Greensboro, NC
  • NPI 1790491751
  NPD

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1720149578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14883",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274154883",
            "telephone_number": "336-274-6515",
            "fax_number": "336-275-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E WENDOVER AVE STE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011232",
            "telephone_number": "336-482-2309",
            "fax_number": "336-268-3157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Robert Porcher Way",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274102190",
            "country_code": "US",
            "telephone_number": "336-268-3280",
            "fax_number": "336-282-0379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "JENNIFER",
        "middle_name": "REEVES",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "102881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.willard@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "301 E Wendover Ave Ste 200",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274011232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Farren Shumake Wilkinson, FNP-C
• Mark Anthony Wilkinson, D.D.S.
• Stacie Wilkinson
• Peter Christian Will, M.D.
• Hannah Willard
• Kristen Willard, PHARMD
• Melissa Kegley Willeford, OT
• Willen Chiropractic Center
• Steve M Willen, DC
• Larry Carl Willett, PHD LPC

• All providers in Greensboro, NC
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.