Active NPI
Jessica A Poulson, MD
- Student in an Organized Health Care Education/Training Program
- Bethesda, VA
National Provider Identifier
1003401845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 0101275844
- Practice address
- Walter Reed National Military Medical Center
8901 Rockville Pike
Bethesda, VA 20814 - Phone
- (703) 928-2831
- NPI assigned
- Mar 3, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 0101275844 | VA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 0101275844 | VA | Primary |
Addresses
Primary practice location
Walter Reed National Military Medical Center
8901 Rockville Pike
Bethesda, VA 20814
Mailing address
Walter Reed National Military Medical Center
8901 Rockville Pike
Bethesda, MD 20814
Phone (703) 928-2831
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101275844 | VA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725408000000",
"number": "1003401845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "WALTER REED NATIONAL MILITARY MEDICAL CENTER",
"address_2": "8901 ROCKVILLE PIKE",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20814",
"telephone_number": "703-928-2831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WALTER REED NATIONAL MILITARY MEDICAL CENTER",
"address_2": "8901 ROCKVILLE PIKE",
"city": "BETHESDA",
"state": "VA",
"postal_code": "20814",
"telephone_number": "703-928-2831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULSON",
"first_name": "JESSICA",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-03",
"last_updated": "2024-09-04",
"certification_date": "2024-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "VA",
"license": "0101275844",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "VA",
"license": "0101275844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.