Individual provider Active NPI

Jessica M S Vittengl, ARNP

  • Nurse Practitioner
  • Bellingham, WA
National Provider Identifier
1073707980
Registry record updated Jul 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30007851 Issued in WA
Practice address
2979 Squalicum Pkwy
Suite 101
Bellingham, WA 98225-1811
Phone
(360) 734-2700
Fax
(360) 734-8362
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30007851 WA Primary
Acute Care Nurse Practitioner 363LA2100X AP30007851 WA

Addresses

Primary practice location

2979 Squalicum Pkwy
Suite 101
Bellingham, WA 98225-1811

Mailing address

PO Box 5096
Bellingham, WA 98227-5096
Phone (360) 734-2700

Other identifiers 5

IdentifierTypeStateIssuer
1073707980MedicaidWA
0280023OtherWAL&I AND CRIME VICTIMS
AF03OtherWATRI WEST (TRICARE)
9654005MedicaidWA
0164VIOtherWAREGENCE BLUE SHIELD

Other names 1

  • Jessica M Saucier Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20211119000188 NH Practitioner - Nurse Practitioner 2365538006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wentworth Douglass Physician CorporationGroup PAC ID 5496749848, 429 clinicians

Practice addresses (Care Compare)

19 Old Rollinsford Rd
BLDG B
Dover, NH 03820-2807
Phone (603) 516-4265

Hospital & facility affiliations

  • Wentworth-Douglass Hospital Hospital, Dover, NH, CCN 300018
  • Huggins Hospital Hospital, Wolfeboro, NH, CCN 301312

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP30007851WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Dec 1, 2021 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Dec 1, 2021 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Westchester Neurological Consultant PC Past Accepting new patients
North Cascade Cardiology PLLC Nurse Practitioner Past Accepting new patients

Locations

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

19 Old Rollinsford Rd
Bldg B
Dover, NH 03820
Phone (603) 516-4265

750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030

67 Corporate Dr
Fl 2
Portsmouth, NH 03801
Phone (603) 610-8078

67 Corporate Dr
Ste 200
Portsmouth, NH 03801
Phone (603) 431-5529

3 Terrascape Pkwy
Somersworth, NH 03878
Phone (603) 609-6726

Interoperability endpoints

  • Direct secure messaging: vittengl.jessica.wdh@direct.partners.masshiway.net
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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 5

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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1073707980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5096",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982275096",
            "telephone_number": "360-734-2700",
            "fax_number": "360-734-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2979 SQUALICUM PKWY",
            "address_2": "SUITE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251811",
            "telephone_number": "360-734-2700",
            "fax_number": "360-734-8362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITTENGL",
        "first_name": "JESSICA",
        "middle_name": "M S",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30007851",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP30007851",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073707980",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I AND CRIME VICTIMS",
            "identifier": "0280023",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI WEST (TRICARE)",
            "identifier": "AF03",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9654005",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "0164VI",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SAUCIER",
            "middle_name": "M",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.