Jeannette V Luther, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10003342 Issued in WA

Practice address

8507 S 5TH St
Suite 113
Ridgefield, WA 98642-3421

Phone

(360) 887-9494

Fax

(360) 887-9498

NPI assigned

Nov 21, 2005

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

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PeacehealthGroup PAC ID 5890689293, 188 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jluther116466@direct.peacehealth.org

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.

• Peacehealth

  • Multi-Specialty Clinic/Center
  • Longview, WA
  • NPI 1720056187
  Medicare reassignment Care Compare group NPD
• Peacehealth

  • Physical Therapist
  • Longview, WA
  • NPI 1275501538
  NPD (past)
• Ridgefield Family Medicine, PLLC

  • Family Medicine Physician
  • Ridgefield, WA
  • NPI 1407229719
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Peacehealth

  • General Acute Care Hospital
  • Longview, WA
  • NPI 1073510277
  Care Compare affiliation

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494892800000",
    "number": "1316920648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 E KESSLER BLVD",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-747-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 S 5TH ST",
            "address_2": "SUITE 113",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986423421",
            "telephone_number": "360-887-9494",
            "fax_number": "360-887-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTHER",
        "first_name": "JEANNETTE",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2017-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8320889",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Ridgefield, WA
• Providers in Ridgefield, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.