Jessica Irene Elligott, CDCES, MS, RDN, CDN

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

DI60596850 Issued in WA

Practice address

2101 NE 139TH St Ste 460
Vancouver, WA 98686-2325

Phone

(360) 360-4872

NPI assigned

Nov 21, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784
  Medicare reassignment NPD
• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1538709803
  NPD
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  NPD
• Legacy Good Samaritan Hospital and Medical Center

  • Clinic/Center
  • Portland, OR
  • NPI 1134750037
  NPD
• Legacy Good Samaritan Hospital and Medical Center

  • Psychiatric Hospital Unit
  • Portland, OR
  • NPI 1336162874
  NPD (past)

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1154967461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19000 SE 23RD ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839794",
            "telephone_number": "360-601-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 NE 139TH ST STE 460",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862325",
            "telephone_number": "360-360-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIGOTT",
        "first_name": "JESSICA",
        "middle_name": "IRENE",
        "credential": "CDCES, MS, RDN, CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-21",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "WA",
            "license": "DI60596850",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "OR",
            "license": "DI60596850",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60596850",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Ellefson, RPH
• Tara Lynn Ellenbest, LMHCA, MA, BA
• Heather Marie Eller, LMP
• Candace Marie Ellerbee, NP
• Janay K Ellett
• Leigh Elling, D.C.
• John Erlend Ellingboe, DPT
• Brooke Mae Elliott, PA-C
• Elizabeth Ballard Elliott, NP
• Ellis Burke Jardine, DMD, PC

• Diabetes Educator Registered Nurse in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Diabetes Educator Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.