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JONATHAN WILLSON
NPI 1215826037
Nurse Practitioner in Broken Arrow, OK

Active since June 30, 2025PECOS Enrolled
109 W COMMERCIAL ST, BROKEN ARROW, OK 74012(918) 887-8300 Get Directions Write a Review

NPPES record last updated: December 18, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Dec 18, 2025, Jun 30, 2025 (2 updates tracked since 2025).

About Jonathan Willson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN WILLSON (NPI 1215826037) is an individual nurse practitioner in Broken Arrow, Oklahoma, licensed in Oklahoma (225851) and active in the NPI registry since June 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1215826037
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameJONATHAN WILLSON
Location Address109 W COMMERCIAL STBroken Arrow, OK 74012-4012
Mailing Address109 W Commercial StBroken Arrow, OK 74012-4012 · (918) 887-8300
Phone(918) 887-8300
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateJune 30, 2025
Last NPPES UpdateDecember 18, 20252 updates tracked since enumeration
NPPES CertifiedDecember 18, 2025
✔ NPI 1215826037 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in OK · 225851
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedRegistered NurseTaxonomy 163W00000X · License R0133031 (OK)
109 W COMMERCIAL ST, Broken Arrow, OK 74012
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jonathan Willson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335625292
PECOS Enrollment IDI20260109002094
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74012 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMANDA SKVORTSOV APRN
Nurse Practitioner (Family)
109 W COMMERCIAL ST
BROKEN ARROW, OK 74012
Tulsa County (918) 887-8300
PETERSON WELLNESS PRIMARY CARE AND PEDIATRICS, PLLC
Clinic/Center (Primary Care)
109 W COMMERCIAL ST
BROKEN ARROW, OK 74012
Tulsa County (918) 724-3952
ASHTON DANIELLE PETERSON
Nurse Practitioner (Family)
109 W COMMERCIAL ST
BROKEN ARROW, OK 74012
Tulsa County (918) 887-8300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Willson's NPI number?

The NPI number for Jonathan Willson is 1215826037. It was assigned to this individual provider in the NPPES registry on June 30, 2025.

Where is Jonathan Willson located?

Jonathan Willson practices at 109 W Commercial St, Broken Arrow, OK 74012. The listed phone number is (918) 887-8300.

What is Jonathan Willson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Jonathan Willson enrolled in Medicare?

Yes. Jonathan Willson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jonathan Willson was last updated on December 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.