Individual provider Active NPI

Jill M Pollock

  • Nurse's Aide
  • Tacoma, WA
National Provider Identifier
1477909117
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
NA60220281 Issued in WA
Practice address
9040 Reid Street
Attn: MCHJ-CLQ-C Madigan Army Medical Center
Tacoma, WA 98431-1100
Phone
(253) 968-1110
Fax
(877) 874-1031
NPI assigned
May 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X NA60220281 WA Primary

Addresses

Primary practice location

9040 Reid Street
Attn: MCHJ-CLQ-C Madigan Army Medical Center
Tacoma, WA 98431-1100

Mailing address

9040 Reid Street
Attn: MCHJ-CLQ-C Madigan Army Medical Center
Tacoma, WA 98431-1100
Phone (253) 968-1110

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

State licenses

LicenseStateTypeSpecialty
NA60220281WAMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1477909117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 REID STREET",
            "address_2": "ATTN: MCHJ-CLQ-C MADIGAN ARMY MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-1110",
            "fax_number": "877-874-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 REID STREET",
            "address_2": "ATTN: MCHJ-CLQ-C MADIGAN ARMY MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-1110",
            "fax_number": "877-874-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "JILL",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "WA",
            "license": "NA60220281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.