Individual provider Active NPI

Jennifer Williams

  • Physician Assistant
  • Yakima, WA
National Provider Identifier
1003007279
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
602 E Nob Hill Blvd
Yakima, WA 98901-3534
Phone
(509) 248-3334
Fax
(509) 453-6144
NPI assigned
Aug 5, 2007
Last updated
Jun 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

602 E Nob Hill Blvd
Yakima, WA 98901-3534

Mailing address

602 E Nob Hill Blvd
Yakima, WA 98901-3534
Phone (509) 248-3334

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwilliams4942@yvfwc.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080121000055 WA Practitioner - Physician Assistant 1658452362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Yakima Valley Dermatology Inc PSGroup PAC ID 9830081470, 8 clinicians

Practice addresses (Care Compare)

3911 Castlevale Rd
Yakima, WA 98902-7807
Phone (509) 966-7899

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic CurrentSince Nov 13, 2015 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Nov 13, 2015 Accepting new patients

Locations

713 Memorial St
Prosser, WA 99350
Phone (509) 786-1931

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

602 E Nob Hill Blvd
Yakima, WA 98901
Phone (509) 248-3334

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ef853cc1-94e4-4ed7-883a-9be7485e458e/
  • Direct secure messaging: jenniferwvalleyderm.net@valley.emadirect.md
  • Direct secure messaging: jwilliams4942@yvfwc.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1003007279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 E NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013534",
            "telephone_number": "509-248-3334",
            "fax_number": "509-453-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 E NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013534",
            "telephone_number": "509-248-3334",
            "fax_number": "509-453-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilliams4942@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "602 E Nob Hill Blvd",
            "city": "Yakima",
            "state": "WA",
            "country_code": "US",
            "postal_code": "989013534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.