Individual provider Active NPI

Billie Jo Wounded Face, P.A.-C

  • Medical Physician Assistant
  • Yuma, AZ
National Provider Identifier
1801864707
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2676 Issued in AZ
Practice address
2400 S Ave a
Yuma, AZ 85364-7127
Phone
(701) 421-7538
Fax
(928) 336-7508
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2676 AZ Primary

Addresses

Primary practice location

2400 S Ave a
Yuma, AZ 85364-7127

Mailing address

2400 S Ave a
Yuma, AZ 85364-7127
Phone (701) 421-7538

Other identifiers 1

IdentifierTypeStateIssuer
329434MedicaidAZ

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2676AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Development of West Phoenix, Inc. Past Accepting new patients
Southwest Emergency Physicians, PLLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1801864707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S AVE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647127",
            "telephone_number": "701-421-7538",
            "fax_number": "928-336-7508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S AVE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647127",
            "telephone_number": "701-421-7538",
            "fax_number": "928-336-7508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOUNDED FACE",
        "first_name": "BILLIE",
        "middle_name": "JO",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329434",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; 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.