Individual provider Active NPI

Jessica Agada, LMP

  • Community Health Worker
  • Seattle, WA
National Provider Identifier
1487950366
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
MA60152456 Issued in WA
Practice address
10030 15TH Ave SW
Seattle, WA 98146-3728
Phone
(206) 763-7464
Fax
(206) 763-8263
NPI assigned
Feb 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X MA60152456 WA Primary

Addresses

Primary practice location

10030 15TH Ave SW
Seattle, WA 98146-3728

Mailing address

10030 15TH Ave SW
Seattle, WA 98146-3728
Phone (206) 763-7464

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
MA60152456WAMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
White Center Chiropractic, PLLC PastSince Jun 16, 2006 Accepting new patients
White Center Chiropractic Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1487950366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10030 15TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981463728",
            "telephone_number": "206-763-7464",
            "fax_number": "206-763-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10030 15TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981463728",
            "telephone_number": "206-763-7464",
            "fax_number": "206-763-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGADA",
        "first_name": "JESSICA",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-09",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "WA",
            "license": "MA60152456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 9, 2011; 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.