Organization Active NPI

Jennifer C Quimby MD Inc PS

  • Specialist
  • Silverdale, WA
National Provider Identifier
1346236742
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD00040782 Issued in WA
Legal business name
JENNIFER C QUIMBY MD INC PS
Practice address
9750 Levin Rd NW
Silverdale, WA 98383-8399
Phone
(360) 307-7202
Fax
(360) 698-6600
NPI assigned
Sep 21, 2005
Last updated
Apr 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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

Authorized official

Name
Dr. Jennifer C Quimby, MD.NPI 1356525802
Title
Owner
Phone
(360) 307-7202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X MD00040782 WA Primary

Addresses

Primary practice location

9750 Levin Rd NW
Silverdale, WA 98383-8399

Mailing address

9750 Levin Rd NW
Silverdale, WA 98383-8399
Phone (360) 307-7202

Other identifiers 1

IdentifierTypeStateIssuer
1119775MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1346236742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9750 LEVIN RD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838399",
            "telephone_number": "360-307-7202",
            "fax_number": "360-698-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9750 LEVIN RD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838399",
            "telephone_number": "360-307-7202",
            "fax_number": "360-698-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER C QUIMBY MD INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "QUIMBY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-307-7202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00040782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1119775",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; 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.