Jennifer Esther Wekenborg, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2019001383 Issued in MO

Practice address

600 E 5TH St
Fulton, MO 65251-1793

Phone

(573) 592-2217

NPI assigned

Jan 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Esther Young Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of MissouriGroup PAC ID 1456254226, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• State of Missouri

  • Psychiatry Physician
  • Fulton, MO
  • NPI 1164477873
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1972076750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E 5TH ST",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511793",
            "telephone_number": "573-592-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 5TH ST",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511793",
            "telephone_number": "573-592-2217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652120001",
            "country_code": "US",
            "telephone_number": "573-882-8913",
            "fax_number": "573-884-1070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEKENBORG",
        "first_name": "JENNIFER",
        "middle_name": "ESTHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2019001383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "YOUNG",
            "middle_name": "ESTHER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul Robert Vossen, RPH
• Wal-Mart Stores East LP
• Walgreen Co
• Teresa Ann Warfield, LPN
• Katelyn Caroline Weith, MD
• Katrina Lea Werthmann
• Westminster College
• Andrew White, DNP, FNP-C
• Kristin White, SLPCF
• Dana Whitford

• Physician Assistant in Fulton, MO
• Providers in Fulton, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.