Individual provider Active NPI

Jennifer Lynn Venable, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Tumwater, WA
National Provider Identifier
1114997541
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61190959 Issued in WA
Practice address
6334 Littlerock Rd SW BLDG 6
Tumwater, WA 98512-7332
Phone
(360) 704-7590
Fax
(360) 704-7591
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61190959 WA Primary

Addresses

Primary practice location

6334 Littlerock Rd SW BLDG 6
Tumwater, WA 98512-7332

Mailing address

6334 Littlerock Rd SW BLDG 6
Tumwater, WA 98512-7332
Phone (360) 704-7590

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
I20230817000117 WA Practitioner - Nurse Practitioner 5890157283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

202 Cullens St NW
Yelm, WA 98597-9417
Phone (360) 400-4800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61190959WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers Current Accepting new patients
Sea-Mar Community Health Center CurrentSince Jul 3, 2023 Accepting new patients
Sea Mar Community Health Centers CurrentSince Jul 3, 2023 Accepting new patients

Locations

3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000

202 Cullens St NW
Yelm, WA 98597
Phone (360) 400-4800

Interoperability endpoints

  • Direct secure messaging: jvenable617589@direct.multicare.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1114997541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6334 LITTLEROCK RD SW BLDG 6",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985127332",
            "telephone_number": "360-704-7590",
            "fax_number": "360-704-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6334 LITTLEROCK RD SW BLDG 6",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985127332",
            "telephone_number": "360-704-7590",
            "fax_number": "360-704-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENABLE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61190959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tumwater, WA

Sources for this page

Verify at the official NPI Registry.