Individual provider Active NPI

Jason A Mounts, M.D.

  • Pediatrics Physician
  • Spokane, WA
National Provider Identifier
1396823811
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101236076 Issued in VA
Practice address
101 W 8TH Ave
Spokane, WA 99204-2307
Phone
(509) 474-5690
NPI assigned
Nov 1, 2006
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101236076 VA Primary
Pediatrics Physician 208000000X 170351 CA
Pediatrics Physician 208000000X MD60150791 WA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X MD60150791 WA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 0101236076 VA

Addresses

Primary practice location

101 W 8TH Ave
Spokane, WA 99204-2307

Mailing address

8521 S Sagewood Rd
Spokane, WA 99223-9272
Phone (509) 979-6930

Other identifiers 1

IdentifierTypeStateIssuer
1396823811MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100929000458 WA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 1658425277 Reassigns benefits to 1 organization
I20210709001537 CA Practitioner - Pediatric Medicine 1658425277 Practice locations: San Luis Obispo, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
170351CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC Pediatrics Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1396823811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8521 S SAGEWOOD RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992239272",
            "telephone_number": "509-979-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-474-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUNTS",
        "first_name": "JASON",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101236076",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "170351",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60150791",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "WA",
            "license": "MD60150791",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "VA",
            "license": "0101236076",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396823811",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.