Willard Dennis Jennings, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

100582 Issued in NC

Practice address

1002 N Church St
Ste 302
Greensboro, NC 27401-1439

Phone

(336) 387-8100

Fax

(336) 387-8202

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1982700092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N CHURCH ST",
            "address_2": "STE 302",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011439",
            "telephone_number": "336-387-8100",
            "fax_number": "336-387-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N CHURCH ST",
            "address_2": "STE 302",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011439",
            "telephone_number": "336-387-8100",
            "fax_number": "336-387-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "WILLARD",
        "middle_name": "DENNIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "100582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rosenbluth
• Deborah Ann Jennings, L.AC
• Glenn E Jennings, M.D.
• Kristin J Jennings, MA
• Patricia Jennings, SLP
• Michaeline Rae Jensen, PH.D.
• Michele Jensen, SLP
• Scott McKenzie Jensen, DMD
• Cory Jentz, DC
• Jeremy Phillips

• Physician Assistant in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.