Tenino Family Practice PLLC

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

Organization subpart

No

Name

Dr. Leyton Endicott Jump, MD

Title

Sole Member

Phone

(360) 264-5665

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Janet Lynn Black, ARNP, RN

  • Family Nurse Practitioner
  • Tenino, WA
  • NPI 1306051867
  NPD (past)
• Kimberly Ireland, ARNP

  • Family Nurse Practitioner
  • Tumwater, WA
  • NPI 1285711358
  NPD (past)
• Carrie Ann Matyac, ARNP

  • Nurse Practitioner
  • Lacey, WA
  • NPI 1669439451
  NPD (past)

• Leyton Jump MD Sole Member Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 19, 2014.

{
    "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"
        }
    ]
}

• Donny Smith
• Claudine Stakelin, SLPA
• Maenell Sullivan, DENTURIST DPD
• Kate M Tallet, LMP
• Tenino Denture Center, LLC
• Tenino School District
• Thurston County Fire Protection District 12
• Alyssa Marie Titus
• Anita E Uy
• Jessica Lyn Valenti, ARNP

• All providers in Tenino, WA
• Adolescent Medicine (Family Medicine) Physician in Washington

• 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.