Individual provider Active NPI

Jane Lynell Ahearn, MD

  • Gynecology Physician
  • Vancouver, WA
National Provider Identifier
1255423380
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD00030075 Issued in WA
Practice address
406-C SE 131St Ave
Suite 304
Vancouver, WA 98683-4004
Phone
(360) 892-4024
Fax
(360) 892-4159
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X MD00030075 WA Primary
Gynecology Physician 207VG0400X MD16405 OR

Addresses

Primary practice location

406-C SE 131St Ave
Suite 304
Vancouver, WA 98683-4004

Mailing address

406-C SE 131St Ave
Suite 304
Vancouver, WA 98683-4004
Phone (360) 892-4024

Other identifiers 2

IdentifierTypeStateIssuer
1113752MedicaidWA
008453OtherOROMAP

Other names 1

  • Jane Lynell Ramp Former name

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
I20101130000679 WA Practitioner - Obstetrics/Gynecology 2860383049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16405ORMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Gynecology Associates PLLC CurrentSince Sep 1, 2002 Accepting new patients

Locations

406 SE 131st Ave
Ste 304
Vancouver, WA 98683
Phone (360) 892-4024

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255423380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406-C SE 131ST AVE",
            "address_2": "SUITE 304",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834004",
            "telephone_number": "360-892-4024",
            "fax_number": "360-892-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406-C SE 131ST AVE",
            "address_2": "SUITE 304",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834004",
            "telephone_number": "360-892-4024",
            "fax_number": "360-892-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHEARN",
        "first_name": "JANE",
        "middle_name": "LYNELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WA",
            "license": "MD00030075",
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OR",
            "license": "MD16405",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1113752",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "008453",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "RAMP",
            "middle_name": "LYNELL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.