Individual provider Active NPI

Jillian Palmer Johnson, P.A.

  • Physician Assistant
  • Arcadia, FL
National Provider Identifier
1770726143
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9105057 Issued in FL
Practice address
1148 E Gibson St
Arcadia, FL 34266-5011
Phone
(863) 494-6222
NPI assigned
Apr 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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 PA9105057 FL Primary

Addresses

Primary practice location

1148 E Gibson St
Arcadia, FL 34266-5011

Mailing address

1148 E Gibson St
Arcadia, FL 34266-5011
Phone (863) 494-6222

Other names 1

  • Jillian Rowe Palmer Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20091016000129 FL Practitioner - Physician Assistant 4486791886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Inc CurrentSince Aug 1, 2022 Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1770726143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 E GIBSON ST",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342665011",
            "telephone_number": "863-494-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 E GIBSON ST",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342665011",
            "telephone_number": "863-494-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JILLIAN",
        "middle_name": "PALMER",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "PALMER",
            "middle_name": "ROWE",
            "credential": "P.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arcadia, FL

Sources for this page

Verify at the official NPI Registry.