Jeanette Geraldine Revay, ARNP PSYCH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP30005089 Issued in WA

Practice address

2747 Pacific Ave SE
Suite B19
Olympia, WA 98501

Phone

(360) 481-7477

Fax

(360) 491-9357

NPI assigned

Sep 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

University of Washington School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

Practice roles

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

• Behavioral Health Resources

  • Community/Behavioral Health Agency
  • Elma, WA
  • NPI 1306918750
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1043313935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2747 PACIFIC AVE SE",
            "address_2": "SUITE B19",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98501",
            "telephone_number": "360-481-7477",
            "fax_number": "360-491-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2747 PACIFIC AVE SE",
            "address_2": "SUITE B19",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98501",
            "telephone_number": "360-481-7477",
            "fax_number": "360-491-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVAY",
        "first_name": "JEANETTE",
        "middle_name": "GERALDINE",
        "name_prefix": "Mrs.",
        "credential": "ARNP PSYCH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30005089",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30005089",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "AP30005089",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Retina and Macula Specialists PS
• Laura Lynn Reubenking
• James Leonard Reus, MD
• William F. Reus III, M.D.
• Shealynn Rene Reuther, BSW
• Kirsten Rewerts
• Courtney Reynolds, MA, LMFTA
• David Joseph Reynolds, PH.D.
• Michelle Dianne Reynolds
• Nichole Briann Reynolds, BACHELOR OF SCIENCE

• Psychiatric/Mental Health Nurse Practitioner in Olympia, WA
• Providers in Olympia, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.