Jennifer C Patton, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP00054373 Issued in WA

Practice address

3510 Steelhammer Dr
Centralia, WA 98531-4551

Phone

(360) 623-8020

NPI assigned

Mar 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cascade Community Healthcare

  • Community/Behavioral Health Agency
  • Centralia, WA
  • NPI 1619068624
  NPD (past)
• Cascade Evaluation and Treatment Center

  • Mental Illness Community Based Residential Treatment Facility
  • Centralia, WA
  • NPI 1760979298
  NPD (past)

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1235764689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 STEELHAMMER DR",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314551",
            "telephone_number": "360-623-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 STEELHAMMER DR",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314551",
            "telephone_number": "360-623-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON",
        "first_name": "JENNIFER",
        "middle_name": "C",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP00054373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2077844",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hari P Pathi, M.D.
• Matthew Scott Patten, MS
• Duane Edward Patterson
• Kevin Bryant Patterson
• Timothy Michael Patterson
• Michelle L Patton, LICSW
• Donna Pauley, CRNA
• Amy Jencina Paulson, CG61113130
• Peach Pointe Adult Family Home LLC
• Angela Pearson

• Licensed Practical Nurse in Centralia, WA
• Providers in Centralia, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.