JON WILLARDSON – Emergency Medicine Physician, NPI 1780819771

JON WILLARDSON is a healthcare provider. based in Augusta, Georgia. specializing in EMERGENCY MEDICINE. They hold a License No. OT012855 (PA). The NPI Number for JON WILLARDSON is 1780819771

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
JON WILLARDSON
NPI
1780819771
Phone
(706) 721-3052
Address
1120 15TH ST
Enumeration Date
20 May 2009
Last Update Date
28 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8017146570
Graduation Year
2009 (17 years ago)
PAC ID
9436396850
Group Practice PAC ID
4789630401
Professional Enrollment ID
I20151120002679
Address ID
UT840032096AM170XX1100300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience81
Completeness75
Years active:17State licenses:3Digital endpointsOther names

1,513 EMERGENCY MEDICINE in GA

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Provider Addresses for JON WILLARDSON

  • Augusta University Medical Center, 1120, 15th Street, Augusta, Richmond County, Georgia, 30912, United States

    AUGUSTA, GA 309120004

    Phone: (706) 721-3052

    Type: Mailing

  • 170 N 1100 E

    AMERICAN FORK, UT 840032096

    Phone: (801) 855-4650

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-11-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20151120002679IEmergency MedicineUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making159150$0
99284Emergency department visit with moderate level of medical decision making8582$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only6359$0
93042Electrocardiogram (ecg) 1 to 3 leads with review by physician only4544$0
99283Emergency department visit with low level of medical decision making1212$0
View full utilization report →

Insurance plans in this area (ZIP 30912)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789630401View full group profile
NameSpecialtyState
Emergency MedicineMI
Emergency MedicineUT
Emergency MedicineUT
Emergency MedicineUT
Emergency MedicineCO
Emergency MedicineGA
-UT
Emergency MedicineUT
Emergency MedicineUT
Emergency MedicineUT

Reviews

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Frequently asked questions

Can I use this page to confirm JON WILLARDSON's NPI?
Yes. JON WILLARDSON is listed with NPI 1780819771 in the public NPI dataset.
Does the file indicate JON WILLARDSON is practicing under active NPI?
Directory data currently reports JON WILLARDSON as active.
What healthcare role does JON WILLARDSON hold?
Scheduling teams often label JON WILLARDSON under Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What area does JON WILLARDSON serve?
JON WILLARDSON's listing highlights Augusta, Georgia; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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