Individual provider Active NPI

Jamie Heathman, PHARMD

  • Pharmacist
  • Lynnwood, WA
National Provider Identifier
1144550955
Registry record updated Dec 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00052282 Issued in WA
Practice address
16824 Hwy 99
Lynnwood, WA 98037-3167
Phone
(425) 741-4302
NPI assigned
Dec 30, 2009
Last updated
Dec 30, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00052282 WA Primary

Addresses

Primary practice location

16824 Hwy 99
Lynnwood, WA 98037-3167

Mailing address

16824 Hwy 99
Lynnwood, WA 98037-3167

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH00052282WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1262131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1144550955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16824 HWY 99",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980373167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16824 HWY 99",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980373167",
            "telephone_number": "425-741-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATHMAN",
        "first_name": "JAMIE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-30",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00052282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.