Individual provider Active NPI

James Alton Willobee, CSA

  • Surgical Physician Assistant
  • Gulf Breeze, FL
National Provider Identifier
1770719155
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1059 Issued in FL
Practice address
5073 Soundside Dr
Gulf Breeze, FL 32563-8921
Phone
(850) 686-3943
NPI assigned
May 30, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1059 FL Primary

Addresses

Primary practice location

5073 Soundside Dr
Gulf Breeze, FL 32563-8921

Mailing address

5073 Soundside Dr
Gulf Breeze, FL 32563-8921
Phone (850) 916-2979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1059FLMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1243641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1770719155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5073 SOUNDSIDE DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325638921",
            "telephone_number": "850-916-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5073 SOUNDSIDE DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325638921",
            "telephone_number": "850-686-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOBEE",
        "first_name": "JAMES",
        "middle_name": "ALTON",
        "credential": "CSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-30",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "1059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.