Jacqueline Marie Ferdowsali, A.G.A.C.N.P

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP60879539 Issued in WA

Practice address

200 NE Mother Joseph PL Ste 330
Vancouver, WA 98664-3288

Phone

(360) 514-2990

NPI assigned

Mar 7, 2013

Last updated

Apr 7, 2020By the provider in NPPES

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 NV, WA, MT, UT, OR5 enrollments

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 5

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jferdowsali419325@direct.peacehealth.org

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.

• Peacehealth

  dba PeaceHealth Medical Group

  • Surgery Physician
  • Vancouver, WA
  • NPI 1609061969
  Medicare reassignment Care Compare group NPD
• Altea Medical Oregon LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Portland, OR
  • NPI 1184451254
  Medicare reassignment NPD
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  OR, WA

  Medicare reassignment NPD
• Utah Regional Hospitalists LLC

  • Hospitalist Physician
  • Murray, UT
  • NPI 1962821223
  Medicare reassignment NPD
• Usacs Integrated Acute Care Services of Nevada Bagnoli P C

  dba Lake Tahoe Regional Hospitalists

  • Hospitalist Physician
  • Carson City, NV
  • NPI 1063608701
  Medicare reassignment
• Utah Regional Hospitalists LLC

  dba Utah Regional Hospitalists

  • Hospitalist Physician
  • Idaho Falls, ID
  • NPI 1740715507

  MT

  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Peacehealth

  dba PeaceHealth SW Heart & Vascular Center

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911

  Hospital

  Care Compare affiliation
• Peacehealth

  dba PeaceHealth Southwest Medical Center

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Care Compare affiliation

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1215278759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4390",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897024390",
            "telephone_number": "775-445-7650",
            "fax_number": "775-882-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 330",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643288",
            "telephone_number": "360-514-2990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1470 Medical Pkwy",
            "address_2": "Suite 160",
            "address_purpose": "LOCATION",
            "city": "Carson City",
            "state": "NV",
            "postal_code": "897034648",
            "country_code": "US",
            "telephone_number": "775-445-7650",
            "fax_number": "775-882-4206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERDOWSALI",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "A.G.A.C.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-07",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60879539",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NV",
            "license": "APN001499",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "11330828-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Marie Fenimore, LMHC
• Dianna Fennessey, L.M.P.
• Katie Elora Fenton
• Karen Ferandes, RC
• Mehdi S Ferdows, MD, PHD
• Kameron Ferdowsali, M.D.
• Daniel E. Ferguson, L.AC.
• Haley Ferguson
• Kalinda R Ferguson
• Liisa Noel Ferguson

• Nurse Practitioner in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.