Individual provider Active NPI

Jordan Wilhelm

  • Physician Assistant
  • Terre Haute, IN
National Provider Identifier
1770297053
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
567 N 5TH St RM 230
Terre Haute, IN 47809-1903
Phone
(812) 237-3632
NPI assigned
Jan 11, 2023
Last updated
Jan 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

567 N 5TH St RM 230
Terre Haute, IN 47809-1903

Mailing address

209 Yukon Pass
Auburn, IN 46706-1049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20251215003542 IN Practitioner - Physician Assistant 9032603238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

7900 W Jefferson Blvd
Suite 306
Fort Wayne, IN 46804-4128
Phone (260) 458-3610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC Physician Assistant CurrentSince Dec 9, 2025 Accepting new patients
Lutheran Medical Group LLC CurrentSince Dec 9, 2025 Accepting new patients

Locations

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

7900 W Jefferson Blvd
Ste 306
Fort Wayne, IN 46804
Phone (260) 458-3610

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1770297053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 YUKON PASS",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467061049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 N 5TH ST RM 230",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478091903",
            "telephone_number": "812-237-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELM",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.