NPIMap

Individual provider Active NPI

Jacqueline Proudfoot, M.D., M.P.H.

  • Family Medicine Physician
  • Belfair, WA
National Provider Identifier
1407261001
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60999446 Issued in WA
Practice address
31 NE State Route 300 Ste 200
Belfair, WA 98528-8668
Phone
(360) 377-3776
NPI assigned
Jun 23, 2014
Last updated
Mar 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X A141233 CA
Family Medicine Physician 207Q00000X 60999446 WA Primary

Addresses

Primary practice location

31 NE State Route 300 Ste 200
Belfair, WA 98528-8668

Mailing address

400 Warren Ave Ste 200
Bremerton, WA 98337-1467
Phone (360) 377-3776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170825003001 CA Practitioner - Family PracticePractitioner - Hospitalist 6901198167 Reassigns benefits to 1 organization
I20191226001111 WA Practitioner - Family Practice 6901198167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

31 NE Rte
300 Suite 200
Belfair, WA 98528
Phone (360) 377-3776

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A141233CAMDFamily Medicine Physician
60999446WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Community Health Services Family Medicine CurrentSince Jun 28, 2024 Accepting new patients
Open Door Community Health Centers CurrentSince Aug 14, 2017 Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers CurrentSince Aug 14, 2017 Accepting new patients
Peninsula Community Health Services Family Medicine Current Accepting new patients
Peninsula Community Health Services Family Medicine Past Accepting new patients
Peninsula Community Health Services Past Accepting new patients

Locations

1275 8th St
Arcata, CA 95521

2200 Tydd St
Eureka, CA 95501
Phone (707) 441-1624

3750 Rohnerville Rd
Fortuna, CA 95540
Phone (707) 725-4477

670 9th St
Ste 203
McKinleyville, CA 95521

31 NE State Route 300
Ste 200
Belfair, WA 98528
Phone (360) 377-3779

616 6th St
Bremerton, WA 98337
Phone (360) 478-2366

320 S Kitsap Blvd
Port Orchard, WA 98366
Phone (360) 876-7215

19917 7th Ave NE
Ste 205
Poulsbo, WA 98370
Phone (360) 697-7636

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13902/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jacqueline.proudfoot.1@13902.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1407261001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WARREN AVE STE 200",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983371467",
            "telephone_number": "360-377-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 NE STATE ROUTE 300 STE 200",
            "city": "BELFAIR",
            "state": "WA",
            "postal_code": "985288668",
            "telephone_number": "360-377-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUDFOOT",
        "first_name": "JACQUELINE",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2022-03-07",
        "certification_date": "2022-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A141233",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "60999446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belfair, WA

Sources for this page

Verify at the official NPI Registry.