Individual provider Active NPI

Jennifer Louise Kurtz, ARNP

  • Critical Care Neonatal Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1174170724
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
TBD Issued in WA
Practice address
315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone
(253) 404-1024
NPI assigned
Aug 19, 2019
Last updated
Dec 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X AP61016241 WA
Critical Care Neonatal Nurse Practitioner 363LN0005X TBD WA Primary

Addresses

Primary practice location

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234

Mailing address

15312 88TH St E
Puyallup, WA 98372-4476
Phone (253) 307-9721

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
I20221018000858 WA Order and Referring Only - Nurse Practitioner 2062897366

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TBDWAMDBehavior Technician
AP61016241WAMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Children's Hospital Past Accepting new patients
Commonspirit Washington Community Care Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jkurtz224276@direct.seattlechildrens.org

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": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1174170724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15312 88TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724476",
            "telephone_number": "253-307-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234",
            "telephone_number": "253-404-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTZ",
        "first_name": "JENNIFER",
        "middle_name": "LOUISE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "WA",
            "license": "AP61016241",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "WA",
            "license": "TBD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.