MEDICARE: DR. JILL ANGELA WARD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083B0002X	Obesity Medicine (Preventive Medicine) Physician	28072	NV
2	207P00000X	Emergency Medicine Physician	01093912A	IN
3	207P00000X	Emergency Medicine Physician	5315241184	MI
4	2083B0002X	Obesity Medicine (Preventive Medicine) Physician	MD2243374	OR
5	207P00000X	Emergency Medicine Physician	4301507937	MI
6	207P00000X	Emergency Medicine Physician	5307014169	MI
7	2083B0002X	Obesity Medicine (Preventive Medicine) Physician	01093912A	IN
8	2083B0002X	Obesity Medicine (Preventive Medicine) Physician	5307014169	MI
9	2083B0002X	Obesity Medicine (Preventive Medicine) Physician	93636	GA
10	207P00000X	Emergency Medicine Physician	93636	GA
11	207P00000X	Emergency Medicine Physician	7171452	ID
12	2083B0002X	Obesity Medicine (Preventive Medicine) Physician	7171452	ID
13	2083B0002X	Obesity Medicine (Preventive Medicine) Physician	ME110689	FL
14	207P00000X	Emergency Medicine Physician	110689	FL
15	207P00000X	Emergency Medicine Physician	FW2754655	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14PL3	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538441316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JILL ANGELA WARD MD

Provider Business Mailing Address
First Line	:	7829 COLLINS GROVE RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-7176
Country	:	US
Telephone Number	:	904-535-4815
Fax Number	:

Provider Business Practice Location Address
First Line	:	5816 N SHELDON RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-3153
Country	:	US
Telephone Number	:	858-775-1700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2011
Last Update Date	:	03/18/2026

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