Individual provider Active NPI

Jennifer J Newman, RD

  • Registered Dietitian
  • Vancouver, WA
National Provider Identifier
1104909266
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI00000934 Issued in WA
Practice address
400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone
(360) 514-3475
Fax
(360) 514-3590
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI00000934 WA Primary

Addresses

Primary practice location

400 NE Mother Joseph PL
Vancouver, WA 98664-3200

Mailing address

400 NE Mother Joseph PL
Vancouver, WA 98664-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101112000041 WA Practitioner - Registered Dietitian Or Nutrition Professional 5597950899 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

16811 SE McGillivray Blvd
Vancouver, WA 98683-3404
Phone (360) 735-8100

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI00000934WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Aug 1, 2002 Accepting new patients
Peacehealth CurrentSince Aug 1, 2002 Accepting new patients

Locations

16811 SE McGillivray Blvd
Vancouver, WA 98683
Phone (360) 514-4900

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

505 NE 87th Ave
Ste 260
Vancouver, WA 98664
Phone (360) 514-6450

2312 NE 129th St
Ste 120
Vancouver, WA 98686
Phone (360) 546-8000

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

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 2

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104909266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200",
            "telephone_number": "360-514-3475",
            "fax_number": "360-514-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00000934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.