Active NPI
Jimmy K Elison, DMD
- Dentist
- Neah Bay, WA
National Provider Identifier
1124158548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- N00822
- Practice address
- 250 Fort Street
Neah Bay, WA 98357 - Phone
- (360) 645-2233
- Fax
- (360) 645-2305
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | N00822 | ID | Primary |
Addresses
Primary practice location
250 Fort Street
Neah Bay, WA 98357
Mailing address
PO Box 410
Neah Bay, WA 98357-0410
Phone (360) 645-2233
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
| License | State | Type | Specialty |
|---|---|---|---|
| N00822 | ID | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124158548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 410",
"city": "NEAH BAY",
"state": "WA",
"postal_code": "983570410",
"telephone_number": "360-645-2233",
"fax_number": "360-645-2305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 FORT STREET",
"city": "NEAH BAY",
"state": "WA",
"postal_code": "98357",
"telephone_number": "360-645-2233",
"fax_number": "360-645-2305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELISON",
"first_name": "JIMMY",
"middle_name": "K",
"name_prefix": "Mr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ID",
"license": "N00822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Neah Bay, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.