NPIMap

Organization Active NPI

Tenino Family Practice PLLC

  • Adolescent Medicine (Family Medicine) Physician
  • Tenino, WA
National Provider Identifier
1487056511
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
License
MD00022762 Issued in WA
Legal business name
TENINO FAMILY PRACTICE PLLC
Practice address
273 Sussex Ave E
Tenino, WA 98589-9359
Phone
(360) 264-5665
Fax
(360) 264-5666
NPI assigned
Sep 19, 2014
Last updated
Sep 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Authorized official

Name
Dr. Leyton Endicott Jump, MDNPI 1790741924
Title
Sole Member
Phone
(360) 264-5665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0000X MD00022762 WA Primary

Addresses

Primary practice location

273 Sussex Ave E
Tenino, WA 98589-9359

Mailing address

PO Box 4020
Tenino, WA 98589-4020
Phone (360) 264-5665

Other names 1

  • Leyton Jump MD Sole Member Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411084800000",
    "number": "1487056511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4020",
            "city": "TENINO",
            "state": "WA",
            "postal_code": "985894020",
            "telephone_number": "360-264-5665",
            "fax_number": "360-264-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 SUSSEX AVE E",
            "city": "TENINO",
            "state": "WA",
            "postal_code": "985899359",
            "telephone_number": "360-264-5665",
            "fax_number": "360-264-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENINO FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A",
        "authorized_official_last_name": "JUMP",
        "authorized_official_first_name": "LEYTON",
        "authorized_official_middle_name": "ENDICOTT",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "360-264-5665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "WA",
            "license": "MD00022762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leyton Jump MD Sole Member",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tenino, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; 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.