Carrie L Jenner, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD00034173 Issued in WA

Practice address

7210 40TH St W
Ste 100
University Place, WA 98466-4237

Phone

(253) 564-0170

Fax

(253) 207-4240

NPI assigned

Aug 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjenner21769@fhsce.catholichealth.net

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.

• Franciscan Medical Group

  dba Westsound Orthopaedics A part of the Franciscan Medical Group

  • Orthopaedic Surgery Physician
  • Silverdale, WA
  • NPI 1093165334
  Medicare reassignment NPD
• Franciscan Medical Group

  dba Franciscan Plastic & Reconstructive Surgery Associates

  • Plastic Surgery Physician
  • Gig Harbor, WA
  • NPI 1750695474
  NPD
• Commonspirit Washington

  dba St Joseph Medical Center

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1952309098
  NPD (past)
• Fox Medical Center

  • Family Medicine Physician
  • University Place, WA
  • NPI 1639748882
  NPD (past)
• Franciscan Medical Group

  dba Franciscan Medical Clinic-Gig Harbor

  • Family Medicine Physician
  • Gig Harbor, WA
  • NPI 1386602555
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1437160140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 40TH ST W",
            "address_2": "STE 100",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664237",
            "telephone_number": "253-564-0170",
            "fax_number": "253-207-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 40TH ST W",
            "address_2": "STE 100",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664237",
            "telephone_number": "253-564-0170",
            "fax_number": "253-207-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNER",
        "first_name": "CARRIE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00034173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "126537",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8208399",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "370013713",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8935092",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane Carol James, RPH
• Joseph Eric Janaszak
• Joseph F Jasper, MD
• Shannon Jean, DDS
• Melanie Jean Jenkins, DMD
• Catherine Dinelle Jerome, LMP
• Jessica M White Nursing Inc (Unpc Family Medicine Clinic)
• Jessica M White, Arnp, Inc (UNPC Family Medicine Clinic)
• Shelley Jette-Kelly, PMHNP
• JMS Corporate Services Group (Homewatch Caregivers of Tacoma)

• Pediatrics Physician in University Place, WA
• Providers in University Place, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.