Individual provider Active NPI

Jefferey Winningham, MD

  • Internal Medicine Physician
  • Everett, WA
National Provider Identifier
1043316110
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00034819 Issued in WA
Practice address
1321 Colby Ave
Medical Staff Office
Everett, WA 98201-1665
Phone
(425) 261-2000
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 34819 WA
Internal Medicine Physician 207R00000X MD00034819 WA Primary

Addresses

Primary practice location

1321 Colby Ave
Medical Staff Office
Everett, WA 98201-1665

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455

Other practice location 1

3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 259-0966

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwinningham125302@wm.providencedirect.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100219000716 WA Practitioner - Internal MedicinePractitioner - Hospitalist 4789728361 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Louisiana State University School of Medicine in New Orleans, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians

Practice addresses (Care Compare)

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

Hospital & facility affiliations

  • Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00034819WAMDInternal Medicine Physician
34819WAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services-Wa CurrentSince Jul 1, 2013 Accepting new patients
Providence Health & Services- Washington CurrentSince Feb 15, 2017 Accepting new patients
Providence Health & Services-Washington CurrentSince Feb 15, 2017 Accepting new patients
Providence Health & Services-Wa Current Accepting new patients
Optum Care Washington PLLC Internal Medicine CurrentSince Dec 23, 2009 Accepting new patients
Optum Care Washington PLLC Internal Medicine CurrentSince Dec 23, 2009 Accepting new patients
Providence Health & Services-Washington CurrentSince Jul 1, 2013 Accepting new patients
Providence Health & Services-Wa Past Accepting new patients

Locations

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

916 Pacific Ave
Fl 7
Everett, WA 98201
Phone (425) 303-6500

1700 13th St
Everett, WA 98201
Phone (425) 252-0895

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903

8910 Vernon Rd
Lake Stevens, WA 98258
Phone (425) 397-1700

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: jwinningham125302@wm.providencedirect.org

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1043316110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLBY AVE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011665",
            "telephone_number": "425-261-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Hoyt Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982014918",
            "country_code": "US",
            "telephone_number": "425-259-0966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINNINGHAM",
        "first_name": "JEFFEREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "34819",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00034819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwinningham125302@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "1321 Colby Ave",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.