Jennifer K Darby
Individual provider Active NPI Family Nurse Practitioner · Sonoma, CA
NPI 1356863831 · NPPES record last updated Jul 17, 2017
Key facts
- NPI
- 1356863831
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95006845 (CA)
- Practice address
- 19270 Sonoma Highway
Sonoma, CA 95476 - Phone
- (707) 939-6070
- NPI assigned
- Jul 17, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Multicare Health System
Practice addresses (Care Compare)
222 State Ave N
Kent, WA 98030-4544
Phone (253) 372-7788
311 S L St
Tacoma, WA 98405-3720
4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706
7096 Lakeland Hills Way SE
Suite 103
Auburn, WA 98092-8438
Phone (253) 545-3650
Hospital & facility affiliations
- Tacoma General Allenmore Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211228000727 | WA | Practitioner - Nurse Practitioner | 2163794041 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000022542 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current |
Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current |
Accepting new patients | |
| Multicare Health System | Past | Accepting new patients |
Locations
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
222 State Ave N
Kent, WA 98030
Phone (253) 372-7680
311 S L St
Tacoma, WA 98405
Phone (253) 403-1444
Interoperability endpoints
- jdarby602911@direct.multicare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0000022542 | TN | |
| Family Nurse Practitioner | 363LF0000X | 95006845 | CA | Yes |
Addresses
Primary practice location
19270 Sonoma Highway
Sonoma, CA 95476
Mailing address
19270 Sonoma Highway
Sonoma, CA 95476
Other providers in Sonoma, CA
- Mark Luck Lito Villa Cubillas
- Jody Alison Culp
- Richard Lee Daffurn
- Kayla A Dale
- Barry Robert Danieli
- Elizabeth Louise Davis
- De Colores Arts
- Charles Francis De Torres
- Decipher One Medical PC
- Darice Elaine Dekker
All providers in Sonoma, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.