Jared Willmore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

200 SE Hospital Ave
Stuart, FL 34994-2346

Phone

(772) 287-5200

NPI assigned

Aug 17, 2016

Sex

Male

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

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: jwillmore286746@ahs.direct-ci.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.

• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199

  ID

  Medicare reassignment
• Rocky Mountain Physician Group LLC

  • Emergency Medicine Physician
  • Pocatello, ID
  • NPI 1851808133
  Medicare reassignment

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1730634916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MAPLE AVE",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834451220",
            "telephone_number": "208-569-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE HOSPITAL AVE",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942346",
            "telephone_number": "772-287-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMORE",
        "first_name": "JARED",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Peck Williamson, RBT
• James H Willis DDS PA, DDS PA
• Michaela Willis
• Naje Willis
• Sade Dallas Willis
• Kasmin Wills, RBT
• Nicole Wilner
• Wilson Physical Therapy. P.a., Inc
• Andrew James Wilson II
• Brooke Wilson

• Physician Assistant in Stuart, FL
• Providers in Stuart, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.