Active NPI
Jamie Stevens
- Licensed Practical Nurse
- Washington, PA
National Provider Identifier
1184073728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN288962
- Practice address
- 50 E Wylie Ave
Suite 2 and 3
Washington, PA 15301-2059 - Phone
- (724) 222-6220
- Fax
- (724) 222-6221
- NPI assigned
- Jun 5, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN288962 | PA | Primary |
Addresses
Primary practice location
50 E Wylie Ave
Suite 2 and 3
Washington, PA 15301-2059
Mailing address
50 E Wylie Ave
Suite 2 and 3
Washington, PA 15301-2059
Phone (724) 222-6220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992170930 | Medicaid | PA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN288962 | PA | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Echo Treatment Center, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba MedMark Treatment Centers Washington
- Methadone Clinic
- Washington, PA
- NPI 1992170930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465084800000",
"number": "1184073728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 E WYLIE AVE",
"address_2": "SUITE 2 AND 3",
"city": "WASHINGTON",
"state": "PA",
"postal_code": "153012059",
"telephone_number": "724-222-6220",
"fax_number": "724-222-6221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 E WYLIE AVE",
"address_2": "SUITE 2 AND 3",
"city": "WASHINGTON",
"state": "PA",
"postal_code": "153012059",
"telephone_number": "724-222-6220",
"fax_number": "724-222-6221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "JAMIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-05",
"last_updated": "2016-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "PA",
"license": "PN288962",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1992170930",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.