Individual provider Active NPI

Jody Rullman Colglazier, R.N.

  • Home Health Registered Nurse
  • Seattle, WA
National Provider Identifier
1457451072
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
00103486 Issued in WA
Practice address
1660 S Columbian Way
Sea-111-HBPC
Seattle, WA 98108-1532
Phone
(206) 764-2173
NPI assigned
Sep 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 00103486 WA Primary

Addresses

Primary practice location

1660 S Columbian Way
Sea-111-HBPC
Seattle, WA 98108-1532

Mailing address

1660 S Columbian Way
Sea-111-HBPC
Seattle, WA 98108-1532
Phone (206) 764-2173

Other identifiers 1

IdentifierTypeStateIssuer
RN 00103486OtherWARN LICENCE

Other names 1

  • Ms. Jody Marie Rullman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
00103486WAMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192147200000",
    "number": "1457451072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 S COLUMBIAN WAY",
            "address_2": "SEA-111-HBPC",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081532",
            "telephone_number": "206-764-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 S COLUMBIAN WAY",
            "address_2": "SEA-111-HBPC",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081532",
            "telephone_number": "206-764-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLGLAZIER",
        "first_name": "JODY",
        "middle_name": "RULLMAN",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WA",
            "license": "00103486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENCE",
            "identifier": "RN 00103486",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODY",
            "last_name": "RULLMAN",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "R.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.