Individual provider Active NPI

Jennifer Ann Elliott, ARNP

  • Family Nurse Practitioner
  • Mount Vernon, WA
National Provider Identifier
1396071601
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60093645 Issued in WA
Practice address
2320 Freeway Dr
Mount Vernon, WA 98273-5445
Phone
(360) 814-6850
Fax
(360) 814-6920
NPI assigned
Oct 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60093645 WA Primary

Addresses

Primary practice location

2320 Freeway Dr
Mount Vernon, WA 98273-5445

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jelliott38125@skagit.direct-ci.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100209000060 WA Practitioner - Nurse Practitioner 8527101872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

2320 Fwy Dr
Mount Vernon, WA 98273-5445
Phone (360) 814-6800

Hospital & facility affiliations

  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60093645WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Feb 28, 2022 Accepting new patients
Sea Mar Community Health Centers Family CurrentSince Feb 2, 2015 Accepting new patients
Sea Mar Community Health Centers Family Current Accepting new patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Feb 28, 2022 Accepting new patients
Sea Mar Community Health Centers CurrentSince Feb 2, 2015 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

3823 172nd St NE
Arlington, WA 98223
Phone (360) 618-5000

4455 Cordata Pkwy
Bellingham, WA 98226
Phone (360) 671-3225

6884 Hannegan Rd
Everson, WA 98247
Phone (360) 354-0766

901 S 5th St
Mount Vernon, WA 98274
Phone (360) 428-6434

2320 Freeway Dr
Mount Vernon, WA 98273
Phone (360) 814-6800

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

Interoperability endpoints

  • Direct secure messaging: jelliott38125@skagit.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1396071601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 FREEWAY DR",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735445",
            "telephone_number": "360-814-6850",
            "fax_number": "360-814-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60093645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jelliott38125@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2320 Freeway Dr",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982735445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.