Active NPI
Jodi Lynn Jeakins-Kok, NURSE PRACTITIONER
- Ambulatory Women's Health Care Registered Nurse
- Missoula, MT
National Provider Identifier
1467678946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Women's Health Care Registered Nurse
- License
- 16154
- Practice address
- 634 Eddy Ave
Missoula, MT 59812-1851 - Phone
- (406) 243-4330
- NPI assigned
- Apr 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Women's Health Care Registered Nurse | 163WW0101X | 16154 | MT | Primary |
Addresses
Primary practice location
634 Eddy Ave
Missoula, MT 59812-1851
Mailing address
9575 Keegan TRL
Missoula, MT 59808-9382
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16154 | Other | MT | RN ID NUMBER |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16154 | MT | MD | Ambulatory Women's Health Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467678946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9575 KEEGAN TRL",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598089382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "634 EDDY AVE",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598121851",
"telephone_number": "406-243-4330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEAKINS-KOK",
"first_name": "JODI",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WW0101X",
"taxonomy_group": "",
"desc": "Registered Nurse, Women's Health Care, Ambulatory",
"state": "MT",
"license": "16154",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN ID NUMBER",
"identifier": "16154",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.