Active NPI
Jeffrey Allen Wallhoff, M.D.
- Family Medicine Physician
- Monroe, WA
National Provider Identifier
1366676330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 53508
- Practice address
- 19200 N Kelsey St
Monroe, WA 98272-1431 - Phone
- (360) 794-7994
- NPI assigned
- May 6, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 53508 | MN | Primary |
Addresses
Primary practice location
19200 N Kelsey St
Monroe, WA 98272-1431
Mailing address
PO Box 3360
Portland, OR 97208-3360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366676330 | Medicaid | MN |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clallam County Public Hospital District No 1 | Past | Accepting new patients |
Interoperability endpoints
- jefferyw@direct.forkshospital.org
- jwallhoff766515@direct.multicare.org
- walje@direct.forkshospital.org
- https://api.qualifacts.org/api/fhir/forkshospital/r4/
Organizations & group practices 2
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.
-
- Critical Access Hospital
- Forks, WA
- NPI 1891879680
-
- Rural Health Clinic/Center
- Clallam Bay, WA
- NPI 1235213034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389312000000",
"number": "1366676330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3360",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19200 N KELSEY ST",
"city": "MONROE",
"state": "WA",
"postal_code": "982721431",
"telephone_number": "360-794-7994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLHOFF",
"first_name": "JEFFREY",
"middle_name": "ALLEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-06",
"last_updated": "2014-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "53508",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1366676330",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monroe, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.