Individual provider Active NPI

Jackson Cooper Bugg, BLS

  • Emergency Medical Services (Emergency Medicine) Physician
  • Sedro Woolley, WA
National Provider Identifier
1538039375
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
B78FCB Issued in WA
Practice address
23603 Old Day Creek Rd
Sedro Woolley, WA 98284-7792
Phone
(564) 900-4511
NPI assigned
Nov 7, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X B78FCB WA Primary

Addresses

Primary practice location

23603 Old Day Creek Rd
Sedro Woolley, WA 98284-7792

Mailing address

23603 Old Day Creek Rd
Sedro Woolley, WA 98284-7792
Phone (564) 900-4511

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
B78FCBWAMDEmergency Medical Services (Emergency Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1762473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1538039375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23603 OLD DAY CREEK RD",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982847792",
            "telephone_number": "564-900-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23603 OLD DAY CREEK RD",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982847792",
            "telephone_number": "564-900-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUGG",
        "first_name": "JACKSON",
        "middle_name": "COOPER",
        "credential": "BLS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-07",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WA",
            "license": "B78FCB",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedro Woolley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; 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.