Individual provider Active NPI

Jane Ritchie Peterson, LM

  • Midwife
  • Kenmore, WA
National Provider Identifier
1376789156
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
MW60068210 Issued in WA
Practice address
15718 76TH PL NE
Kenmore, WA 98028-4236
Phone
(425) 239-5753
NPI assigned
Dec 27, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X MW60068210 WA Primary

Addresses

Primary practice location

15718 76TH PL NE
Kenmore, WA 98028-4236

Mailing address

15718 76TH PL NE
Kenmore, WA 98028-4236
Phone (425) 239-5753

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

State licenses

LicenseStateTypeSpecialty
MW60068210WAMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1230336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263859200000",
    "number": "1376789156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15718 76TH PL NE",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980284236",
            "telephone_number": "425-239-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15718 76TH PL NE",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980284236",
            "telephone_number": "425-239-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JANE",
        "middle_name": "RITCHIE",
        "credential": "LM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-27",
        "last_updated": "2010-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "WA",
            "license": "MW60068210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.