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JACK ANDREW WILL
NPI 1386445278
Student in an Organized Health Care Education/Training Program in Fort Worth, TX

Active since March 24, 2025PECOS Enrolled
1651 W ROSEDALE ST, FORT WORTH, TX 76104(817) 257-4212 Get Directions Write a Review

NPPES record last updated: March 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jack Andrew Will NPPES

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

JACK ANDREW WILL (NPI 1386445278) is an individual student in an organized health care education/training program in Fort Worth, Texas and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386445278
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACK ANDREW WILL
Location Address1651 W ROSEDALE STFort Worth, TX 76104-7437
Mailing Address1651 W Rosedale StFort Worth, TX 76104-7437
Phone(817) 257-4212
Sole ProprietorYes
Enumeration DateMarch 24, 2025
NPPES CertifiedMarch 24, 2025
✔ NPI 1386445278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1651 W ROSEDALE ST, Fort Worth, TX 76104
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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)

Jack Andrew Will is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 8

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

CINDY LITTLEHALE
Specialist/Technologist (Athletic Trainer)
1651 W ROSEDALE ST, SUITE 200
FORT WORTH, TX 76104
Tarrant County (817) 810-0001
WILLIAM HORACE MITCHELL M.D.
Orthopaedic Surgery
1651 W ROSEDALE ST, SUITE 200
FORT WORTH, TX 76104
Tarrant County (817) 335-4316
TARRA LEIGH POWER SAHIM DPT, MSPT, CSCS, ATC
Physical Therapist
1651 W ROSEDALE ST, SUITE 200
FORT WORTH, TX 76104
Tarrant County (817) 810-0001
TEXAS HEALTH CARE, PLLC
Non-Pharmacy Dispensing Site
1651 W ROSEDALE ST, SUITE 200
FORT WORTH, TX 76104
Tarrant County (817) 335-4316
TORRANCE ANTHONY WALKER M.D.
Orthopaedic Surgery
1651 W ROSEDALE ST, SUITE 200
FORT WORTH, TX 76104
Tarrant County (817) 335-4316
DR. JUSTIN WALTER FAIRLESS DO
Emergency Medicine
1651 W ROSEDALE ST
FORT WORTH, TX 76104
Tarrant County (817) 257-6633
DR. MAHA KHAN MD
Surgery
1651 W ROSEDALE ST
FORT WORTH, TX 76104
Tarrant County (817) 257-4212
DR. SAMUEL HARALDSON M.D.
Emergency Medicine
1651 W ROSEDALE ST, #200
FORT WORTH, TX 76104
Tarrant County (817) 335-4316

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 Jack Will's NPI number?

The NPI number for Jack Will is 1386445278. It was assigned to this individual provider in the NPPES registry on March 24, 2025.

Where is Jack Will located?

Jack Will practices at 1651 W Rosedale St, Fort Worth, TX 76104. The listed phone number is (817) 257-4212.

What is Jack Will's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jack Will enrolled in Medicare?

Yes. Jack Will is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Will was last updated on March 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.