Jennifer McDonald Willard, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

9701657 Issued in NC

Practice address

1030 Siena Drive
Raleigh, NC 27587-2781

Phone

(919) 235-6511

Fax

(919) 341-3578

NPI assigned

Jan 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA, NC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwillard566072@directhisp.wakemed.org

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.

• Wake Specialty Physicians, LLC

  • Surgery Physician
  • Raleigh, NC
  • NPI 1942440375

  Pediatrics

  Medicare reassignment NPD
• Au Medical Associates Inc

  • Multi-Specialty Clinic/Center
  • Augusta, GA
  • NPI 1841230620
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Wake Specialty Physicians LLC

  dba WakeMed Childrens Pediatric Primary Care - Fuquay-Varina Medical Park

  • Pediatrics Physician
  • Fuquay Varina, NC
  • NPI 1578334892
  NPD
• Wake Specialty Physicians, LLC

  dba WakeMed Pediatrics

  • Pediatrics Physician
  • Raleigh, NC
  • NPI 1427469469
  NPD
• Au Medical Associates Inc

  dba Augusta University Health West Wheeler

  • Durable Medical Equipment & Medical Supplies
  • Augusta, GA
  • NPI 1114574126
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1750352423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 SIENA DRIVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "275872781",
            "telephone_number": "919-235-6511",
            "fax_number": "919-341-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "JENNIFER",
        "middle_name": "MCDONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NC",
            "license": "9701657",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9701657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891197N",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750352423",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hilary Lichty Wilkinson, M.S., L.P.C
• Marian Elaine Wilkinson
• Megan Wilkinson
• Hannah Grace Willard, PA
• Hugh Jerome Willard, M.ED., LPC
• Ronnie D Willard, RPH
• Thomas James Willauer, DPT
• Willcare Health Services LLC (WillCare Health Services)
• Joye K Willcox, PHD,RD,LDN
• Michelle M Wille, PHARMD

• Pediatrics Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.