Individual provider Active NPI

Jason Kittredge, MD

  • Family Medicine Physician
  • Gig Harbor, WA
National Provider Identifier
1174986087
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61026142 Issued in WA
Practice address
4700 Point Fosdick Dr Ste 102
Gig Harbor, WA 98335-1706
Phone
(253) 853-2050
Fax
(253) 852-2711
NPI assigned
Mar 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 52855 KY
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD61026142 WA Primary

Addresses

Primary practice location

4700 Point Fosdick Dr Ste 102
Gig Harbor, WA 98335-1706

Mailing address

4700 Point Fosdick Dr Ste 102
Gig Harbor, WA 98335-1706
Phone (253) 853-2050

Other practice location 1

7926 Preston Hwy Ste 106
Louisville, KY 40219-3848
Phone (502) 964-4357

Other identifiers 1

IdentifierTypeStateIssuer
2162974MedicaidWA

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/
Direct Messaging Address jkittredge71023@direct.nortonhealthcare.org
Direct Messaging Address jkittredge639459@fhsce.catholichealth.net Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201014002645 WA Practitioner - Family PracticePractitioner - Other (Physician) 3971876855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2016
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)

4700 Point Fosdick Dr NW
Suite 102
Gig Harbor, WA 98335-1706
Phone (253) 853-2050

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52855KYMDFamily Medicine Physician
MD61026142WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Family Medicine CurrentSince Oct 5, 2020 Accepting new patients
Franciscan Medical Group Family Medicine CurrentSince Oct 5, 2020 Accepting new patients

Locations

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

4700 Point Fosdick Dr
Ste 102
Gig Harbor, WA 98335
Phone (206) 858-3200

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

Organizations & group practices 3

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 5

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": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1174986087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR STE 102",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-853-2050",
            "fax_number": "253-852-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 POINT FOSDICK DR STE 102",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351706",
            "telephone_number": "253-853-2050",
            "fax_number": "253-852-2711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7926 Preston Hwy Ste 106",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402193848",
            "country_code": "US",
            "telephone_number": "502-964-4357",
            "fax_number": "502-966-5948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITTREDGE",
        "first_name": "JASON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "52855",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61026142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2162974",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "7926 Preston Hwy Ste 106",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402193848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkittredge71023@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "7926 Preston Hwy Ste 106",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402193848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkittredge639459@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4700 Point Fosdick Dr Ste 102",
            "city": "Gig Harbor",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983351706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

Verify at the official NPI Registry.