Active NPI
Jackson Simosi Nyarangi
- Other Technician
- Seattle, WA
National Provider Identifier
1265212419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 1116 Summit Ave
Seattle, WA 98101-2831 - Phone
- (206) 323-0930
- NPI assigned
- Oct 4, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 60905751 | WA | |
| Other Technician | 247200000X | Primary |
Addresses
Primary practice location
1116 Summit Ave
Seattle, WA 98101-2831
Mailing address
1116 Summit Ave
Seattle, WA 98101-2831
Phone (206) 323-0930
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 |
|---|---|---|---|
| 60905751 | WA | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696982400000",
"number": "1265212419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1116 SUMMIT AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012831",
"telephone_number": "206-323-0930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1116 SUMMIT AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012831",
"telephone_number": "206-323-0930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYARANGI",
"first_name": "JACKSON",
"middle_name": "SIMOSI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-04",
"last_updated": "2023-10-11",
"certification_date": "2023-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "WA",
"license": "60905751",
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.