Individual provider Active NPI

Jessica Ann Yoder, MD

  • Family Medicine Physician
  • Harrisonburg, VA
National Provider Identifier
1063635522
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01012685144 Issued in VA
Practice address
1661 S Main St
Harrisonburg, VA 22801-2728
Phone
(540) 564-7300
Fax
(757) 579-8580
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 48080 CO
Family Medicine Physician 207Q00000X 01012685144 VA Primary

Addresses

Primary practice location

1661 S Main St
Harrisonburg, VA 22801-2728

Mailing address

11245 Huron St
Westminster, CO 80234-2806
Phone (303) 338-4545

Other identifiers 3

IdentifierTypeStateIssuer
1063635522MedicaidVA
91259568MedicaidCO
020868OtherCOKAISER COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20230918001522 HI Practitioner - Family Practice 0648463257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

55 Maui Lani Pkwy
Wailuku, HI 96793-2416
Phone (808) 243-6050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48080COMDFamily Medicine Physician
01012685144VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Permanente Medical Group Inc CurrentSince Aug 14, 2023 Accepting new patients

Locations

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

55 Maui Lani Pkwy
Wailuku, HI 96793
Phone (808) 243-6000

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.

Hospital & facility affiliations 1

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1063635522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11245 HURON ST",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "802342806",
            "telephone_number": "303-338-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 S MAIN ST",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228012728",
            "telephone_number": "540-564-7300",
            "fax_number": "757-579-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YODER",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "48080",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "01012685144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063635522",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91259568",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "020868",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

Verify at the official NPI Registry.