Individual provider Active NPI

John Jesse Yoo, MS, RN, CPNP

  • Pediatric Nurse Practitioner
  • Edmonds, WA
National Provider Identifier
1285832949
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
167086 Issued in CO
Practice address
9816 234TH PL SW
Edmonds, WA 98020-5662
Phone
(206) 629-4424
NPI assigned
Jul 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 167086 CO Primary

Addresses

Primary practice location

9816 234TH PL SW
Edmonds, WA 98020-5662

Mailing address

9816 234TH PL SW
Edmonds, WA 98020-5662
Phone (206) 629-4424

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
Credentials
Certified Pediatric Nurse Practitioner, Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
167086COMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1183507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1285832949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9816 234TH PL SW",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980205662",
            "telephone_number": "206-629-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9816 234TH PL SW",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980205662",
            "telephone_number": "206-629-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "JOHN",
        "middle_name": "JESSE",
        "name_prefix": "Mr.",
        "credential": "MS, RN, CPNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-04",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "167086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; 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.