Individual provider Active NPI

Jason Leslie McCarty, CG61021888

  • Peer Specialist
  • Spokane, WA
National Provider Identifier
1063174985
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
CG61021888 Issued in WA
Practice address
901 N Monroe St Ste 200
Spokane, WA 99201-2148
Phone
(509) 413-2950
Fax
(509) 241-1866
NPI assigned
Oct 7, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 175T00000X CG61021888 WA Primary

Addresses

Primary practice location

901 N Monroe St Ste 200
Spokane, WA 99201-2148

Mailing address

901 N Monroe St Ste 200
Spokane, WA 99201-2148
Phone (509) 413-2950

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL ReviveCounselingSpokane Health Information Exchange (HIE)

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

State licenses

LicenseStateTypeSpecialty
CG61021888WAMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1063174985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N MONROE ST STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012148",
            "telephone_number": "509-413-2950",
            "fax_number": "509-241-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N MONROE ST STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012148",
            "telephone_number": "509-413-2950",
            "fax_number": "509-241-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTY",
        "first_name": "JASON",
        "middle_name": "LESLIE",
        "credential": "CG61021888",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG61021888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ReviveCounselingSpokane",
            "affiliation": "N",
            "endpointDescription": "MentalHealth",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "901 N Monroe St Ste 200",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992012148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.