Individual provider Active NPI

Joshua Garrett Jennings, APRN-DNP-AG

  • Gerontology Nurse Practitioner
  • Bellevue, WA
National Provider Identifier
1063126282
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
61394796 Issued in WA
Practice address
11120 NE 33Rd PL Ste 202
Bellevue, WA 98004-1444
Phone
(206) 823-1004
NPI assigned
Jan 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 61394796 WA Primary

Addresses

Primary practice location

11120 NE 33Rd PL Ste 202
Bellevue, WA 98004-1444

Mailing address

5403 Columbia Dr S Unit a
Seattle, WA 98108-1926
Phone (360) 223-7714

Other names 1

  • Joshua Jennings Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL GRIMED Health Information Exchange (HIE)

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
I20230124002801 WA Practitioner - Nurse Practitioner 2163893447 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novari Primary Care LLCGroup PAC ID 3476815051, 19 clinicians

Practice addresses (Care Compare)

4686 Pointes Dr
Suite 219
Mukilteo, WA 98275-6038
Phone (425) 405-8089

Hospital & facility affiliations

  • Evergreenhealth Home Care Services Home health agency, Kirkland, WA, CCN 507079
  • Assured Home Health Home health agency, Mountlake Terrace, WA, CCN 507099
  • Providence at Home With Compassus, Snohomish County Home health agency, Everett, WA, CCN 507065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61394796WAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Post Acute Medical PLLC CurrentSince Aug 21, 2023 Accepting new patients
Novari Primary Care LLC Gerontology CurrentSince Oct 25, 2024 Accepting new patients
Seattle SNF Operations, LLC Past Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

4686 Pointes Dr
Ste 219
Mukilteo, WA 98275
Phone (425) 405-8089

4686 Pointes Dr
Mukilteo, WA 98275
Phone (425) 405-8089

6220 S Alaska St
Tacoma, WA 98408
Phone (253) 473-2273

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1063126282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5403 COLUMBIA DR S UNIT A",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081926",
            "telephone_number": "360-223-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 NE 33RD PL STE 202",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041444",
            "telephone_number": "206-823-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JOSHUA",
        "middle_name": "GARRETT",
        "credential": "APRN-DNP-AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "61394796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "GRIMED",
            "affiliation": "N",
            "endpointDescription": "GRIMED",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11120 NE 33rd Pl Ste 202",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980041444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JOSHUA",
            "last_name": "JENNINGS",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.