JACKIE WILLMS
NPI 1336094390
Anesthesiologist Assistant in Grove City, OH

Q: What is Jackie Willms's NPI number?

The NPI number for Jackie Willms is 1336094390. It was assigned to this individual provider in the NPPES registry on March 3, 2026.

Q: What is Jackie Willms's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Jackie Willms was last updated on March 3, 2026. 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.

Active since March 03, 2026Accepts Medicare Assignment

2145 STAGHORN WAY, GROVE CITY, OH 43123(330) 419-1080 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Jackie Willms NPPES

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

JACKIE WILLMS (NPI 1336094390) is an individual anesthesiologist assistant in Grove City, Ohio and active in the NPI registry since March 2026. She is affiliated with Mercy Hospital St Louis and is a graduate of Other (2026).

NPPES Registry Identity

NPI1336094390

Entity TypeIndividualFemale

Primary Taxonomy367H00000X

Provider Legal NameJACKIE WILLMS

Location Address2145 STAGHORN WAYGrove City, OH 43123-4873

Mailing Address2145 Staghorn WayGrove City, OH 43123-4873 · (330) 419-1080

Phone(330) 419-1080

Sole ProprietorNo

Medical School CMSOtherGraduated 2026

Enumeration DateMarch 3, 2026

NPPES CertifiedMarch 3, 2026

✔ NPI 1336094390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

2145 STAGHORN WAY, Grove City, OH 43123

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jackie Willms is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42783888

PECOS Enrollment IDI20260624000924

Medicare Billing Reassignment

Medicare enrollment records show Jackie Willms reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Western Anesthesiology Associates, Inc.

404 mi

Anesthesiology

615 S NEW BALLAS RD, DEPT. OF ANESTHESIA
Saint Louis, MO 63141

Reassigned Medicare billing, Missouri enrollment
309 clinicians in this Medicare group

NPI 1275646754 (636) 386-9224

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercy Hospital St Louis

Acute Care Hospitals · Saint Louis, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260020

Location615 New Ballas RoadSaint Louis, MO 63141 · St. Louis County

Emergency services Birthing friendly

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 Jackie Willms's NPI number?

The NPI number for Jackie Willms is 1336094390. It was assigned to this individual provider in the NPPES registry on March 3, 2026.

Where is Jackie Willms located?

Jackie Willms practices at 2145 Staghorn Way, Grove City, OH 43123. The listed phone number is (330) 419-1080.

What is Jackie Willms's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Jackie Willms enrolled in Medicare?

Yes. Jackie Willms is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jackie Willms's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jackie Willms reassigns Medicare benefits to Western Anesthesiology Associates, Inc. (Saint Louis, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jackie Willms's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jackie Willms affiliated with any hospitals?

According to CMS data, Jackie Willms is affiliated with Mercy Hospital St Louis.

When was this NPI record last updated?

The NPPES record for Jackie Willms was last updated on March 3, 2026. 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.