Individual provider Active NPI

Jennifer A Nelson, ARNP

  • Family Nurse Practitioner
  • Shelton, WA
National Provider Identifier
1043611429
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP Issued in WA
Practice address
237 Professional Way
Shelton, WA 98584-4404
Phone
(360) 426-2500
NPI assigned
Sep 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP WA Primary

Addresses

Primary practice location

237 Professional Way
Shelton, WA 98584-4404

Mailing address

237 Professional Way
Shelton, WA 98584-4404
Phone (360) 426-2500

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
I20201012002830 WA Practitioner - Nurse Practitioner 9739300203 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APWAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 1 of Mason County Current Accepting new patients

Locations

1701 N 13th St
Shelton, WA 98584
Phone (360) 426-2653

237 Professional Way
Shelton, WA 98584
Phone (360) 426-2500

901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1043611429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 PROFESSIONAL WAY",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844404",
            "telephone_number": "360-426-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 PROFESSIONAL WAY",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985844404",
            "telephone_number": "360-426-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

Verify at the official NPI Registry.