Organization Active NPI

Choice Family Medicine LLC

  • Adult Medicine Physician
  • Walla Walla, WA
National Provider Identifier
1275057655
Registry record updated Dec 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
CHOICE FAMILY MEDICINE LLC
Practice address
135 Thorne St
Walla Walla, WA 99362-3142
Phone
(509) 876-9707
Fax
(509) 955-1339
NPI assigned
Jul 27, 2017
Last updated
Dec 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2018

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

Authorized official

Name
Dr. Christopher K Jenkins, DONPI 1962495994
Title
Physician/Owner
Phone
(509) 876-9707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X NU Primary

Addresses

Primary practice location

135 Thorne St
Walla Walla, WA 99362-3142

Mailing address

135 Thorne St
Walla Walla, WA 99362-3142
Phone (509) 529-5831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171020000898 WA Part B Supplier - Clinic/Group Practice 7618243510 Receives reassigned benefits from 3 practitioners
Practice locations: Walla Walla, WA; College Place, WA

National Provider Directory

National Provider Directory

Locations

92 Wainwright Dr
Walla Walla, WA 99362
Phone (360) 895-4710

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545782400000",
    "number": "1275057655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 THORNE ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623142",
            "telephone_number": "15095295831",
            "fax_number": "509-955-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 THORNE ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623142",
            "telephone_number": "509-876-9707",
            "fax_number": "509-955-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICE FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-27",
        "last_updated": "2018-12-26",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "509-876-9707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.