Individual
JACK MONROE VISCA
Active
Individual
JACK MONROE VISCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
7121
TN
363AS0400X
Surgical Physician Assistant
Primary
7121
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q112201
—
TN
Enumeration date
04/08/2026
Last updated
05/04/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up