DR. JENNIFER M WILLARD (NPI# 1750352423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750352423 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER M WILLARD |
| Credential | M.D. |
| Practice Address |
201 E Matthews St Matthews NC 28105-5027 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7048470572 |
| Practice Fax Number | 7048479760 |
| Mailing Telephone | 7048470572 |
| Mailing Fax Number | 7048479760 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2015-03-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 9701657 | NC | Allopathic & Osteopathic Physicians |
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
9701657 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 891197N | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972077535 | Jennifer Willard | Occupational Therapist | 15 W 20th St Apt 4b, New York, NY 10011-3738 | 2019-01-17 |
| 1427203330 | Jennifer Willard | Occupational Therapist | 253 Washington Ave Apt C1, Brooklyn, NY 11205-4280 | 2008-11-19 |
| 1538653795 | Jennifer L Willard | Licensed Practical Nurse | 4500 Stuart St, Columbia, SC 29207-5700 | 2018-06-20 |
| 1235375114 | Jennifer Hastings Willard | Nurse Practitioner | 8 Century Pines Dr, Suite 2, Barrington, NH 03825-3732 | 2008-12-26 |
| 1720149578 | Jennifer Reeves Willard | Physician Assistant | 3800 Robert Porcher Way, Suite 200, Greensboro, NC 27410-2190 | 2006-12-13 |
| Street Address |
201 E MATTHEWS ST |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-5027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275532731 | Varsha Pherwani | Pediatrics | 201 E Matthews St, Matthews, NC 28105-5027 | 2005-07-18 |
| 1598086167 | Valerie A Martin | Pediatrics | 201 E Matthews St, Matthews, NC 28105-5027 | 2010-06-18 |
| 1205064045 | Deloris Rebecca Hobson | Nurse Practitioner | 201 E Matthews St, Matthews, NC 28105-5027 | 2009-07-01 |
| 1205070984 | Novant Medical Group, Inc | Pediatrics | 201 E Matthews St, Matthews, NC 28105-5027 | 2009-04-27 |
| 1700024882 | Natasha Halmi Goins | Pediatrics | 201 E Matthews St, Matthews, NC 28105-5027 | 2009-01-28 |
| 1447474721 | Ami Patel Romanowski | Pediatrics | 201 E Matthews St, Matthews, NC 28105-5027 | 2007-04-11 |
| 1972574796 | Robert Alan Goins | Pediatrics | 201 E Matthews St, Matthews, NC 28105-5027 | 2006-01-30 |
| 1164493029 | Hala A Elhemaily | Pediatrics | 201 E Matthews St, Matthews, NC 28105-5027 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| Find all providers in zip 28105 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003235292 | Scott Warren Thomas | Pediatrics | 1401 Matthews Township Pkwy Ste 100, Matthews, NC 28105-5403 | 2014-04-15 |
| 1205196037 | Courtney Self | Pediatrics | 201 E Matthews St Ste 100, Matthews, NC 28105 | 2012-05-28 |
| 1679532055 | Rolande C. Romain | Pediatrics | 3030 Senna Dr, Matthews, NC 28105-6726 | 2006-03-22 |
| 1275532731 | Varsha Pherwani | Pediatrics | 201 E Matthews St, Matthews, NC 28105-5027 | 2005-07-18 |
| 1144631912 | Meredith Calcina Davitte | Pediatrics | 1401 Matthews Township Pkwy Ste 100, Matthews, NC 28105-5403 | 2014-05-15 |
| 1598086167 | Valerie A Martin | Pediatrics | 201 E Matthews St, Matthews, NC 28105-5027 | 2010-06-18 |
| 1700024882 | Natasha Halmi Goins | Pediatrics | 201 E Matthews St, Matthews, NC 28105-5027 | 2009-01-28 |
| 1245453851 | Latonya Danielle Griffin | Pediatrics | 1401 Matthews Township Pkwy, Suite 320, Matthews, NC 28105-5402 | 2007-04-11 |
| 1447474721 | Ami Patel Romanowski | Pediatrics | 201 E Matthews St, Matthews, NC 28105-5027 | 2007-04-11 |
| 1750419842 | Tanvi Naresh Desai | Pediatrics | 1401 Matthews Township Pkwy, Matthews, NC 28105-5402 | 2007-03-01 |
| Find all providers in MATTHEWS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.