Individual provider Active NPI

Jennifer Williams, MD

  • Family Medicine Physician
  • Olympia, WA
National Provider Identifier
1396807632
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00039230 Issued in WA
Practice address
700 Lilly Rd NE
Olympia, WA 98506-5115
Phone
(360) 923-7000
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OP00001221 WA
Family Medicine Physician 207Q00000X MD00039230 WA Primary

Addresses

Primary practice location

700 Lilly Rd NE
Olympia, WA 98506-5115

Mailing address

700 Lilly Rd NE
Olympia, WA 98506-5115
Phone (360) 923-7000

Other identifiers 1

IdentifierTypeStateIssuer
8283970MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080124000221 WA Practitioner - Family Practice 3476635897 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00039230WAMDFamily Medicine Physician
OP00001221WAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince Sep 4, 2001 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 4, 2001 Accepting new patients

Locations

14701 179th Ave SE
Monroe, WA 98272
Phone (360) 794-1409

3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000

700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

5821 S Sprague Ct
Tacoma, WA 98409
Phone (253) 396-4200

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: jwilliamsmd57027@ghc.direct-ci.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1396807632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065115",
            "telephone_number": "360-923-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065115",
            "telephone_number": "360-923-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "OP00001221",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00039230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8283970",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.