Individual provider Active NPI

Jami L Mock, ARNP

  • Family Nurse Practitioner
  • Poulsbo, WA
National Provider Identifier
1144896390
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61259121 Issued in WA
Practice address
22180 Olympic College Way NW Ste 102
Poulsbo, WA 98370-6664
Phone
(360) 779-4444
Fax
(360) 697-2514
NPI assigned
May 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN60465549 WA
Nurse Practitioner 363L00000X AP61259121 WA
Family Nurse Practitioner 363LF0000X AP61259121 WA Primary

Addresses

Primary practice location

22180 Olympic College Way NW Ste 102
Poulsbo, WA 98370-6664

Mailing address

22180 Olympic College Way NW Ste 102
Poulsbo, WA 98370-6664
Phone (360) 779-4444

Other identifiers 1

IdentifierTypeStateIssuer
2209334MedicaidWA

Other names 1

  • Jami Smart Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mjamie63761@fhsce.catholichealth.net Direct Franciscan Medical Group

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
I20220603001949 WA Practitioner - Nurse Practitioner 8022496066 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
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

5741 N 26TH St
Unit 115
Tacoma, WA 98407-2415
Phone (253) 756-3737

Hospital & facility affiliations

  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN60465549WAMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince May 23, 2022 Accepting new patients
Scandia Creek Collective LLC Current Accepting new patients
Franciscan Medical Group CurrentSince May 23, 2022 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

4205 Kitsap Way
Bremerton, WA 98312
Phone (360) 782-7780

450 S Kitsap Blvd
Ste 100
Port Orchard, WA 98366
Phone (360) 744-6275

22180 Olympic College Way NW
Ste 102
Poulsbo, WA 98370
Phone (360) 779-4444

1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

5741 N 26th St
Unit 115
Tacoma, WA 98407
Phone (253) 756-3737

Organizations & group practices 4

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 4

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": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1144896390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22180 OLYMPIC COLLEGE WAY NW STE 102",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706664",
            "telephone_number": "360-779-4444",
            "fax_number": "360-697-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22180 OLYMPIC COLLEGE WAY NW STE 102",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706664",
            "telephone_number": "360-779-4444",
            "fax_number": "360-697-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "JAMI",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "WA",
            "license": "RN60465549",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61259121",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61259121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2209334",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjamie63761@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "22180 Olympic College Way NW Ste 102",
            "city": "Poulsbo",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983706664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JAMI",
            "last_name": "SMART",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Poulsbo, WA

Sources for this page

Verify at the official NPI Registry.