Individual provider Active NPI

Jane A Whetzel, ARNP

  • Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1558470393
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30006372 Issued in WA
Practice address
801 W 5TH Ave
Suite 518
Spokane, WA 99204-2823
Phone
(509) 747-3147
Fax
(509) 747-0020
NPI assigned
Aug 29, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30006372 WA Primary

Addresses

Primary practice location

801 W 5TH Ave
Suite 518
Spokane, WA 99204-2823

Mailing address

4341 Springdale Hunters Rd
Springdale, WA 99173-9713
Phone (509) 258-9624

Other identifiers 2

IdentifierTypeStateIssuer
142619OtherWAL&I
8322489MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161024000984 MT Practitioner - Nurse Practitioner 9335129493 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missoula Community Health Services, IncGroup PAC ID 6709790603, shared by 4 NPIs, 6 clinicians

Practice addresses (Care Compare)

1208 6TH Ave
Superior, MT 59872-9667
Phone (406) 822-4841

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Physician Assistant

State licenses

LicenseStateTypeSpecialty
AP30006372WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Missoula Community Health Services, Inc CurrentSince Jan 1, 2019 Accepting new patients
Missoula Community Health Services, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Missoula Community Health Services, Inc Current Accepting new patients
Missoula Community Health Services, Inc. CurrentSince Jan 21, 2019 Accepting new patients
Spokane Urology PLLC Past Accepting new patients

Locations

1208 6th Ave
Superior, MT 59872
Phone (406) 683-3401

Organizations & group practices 5

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1558470393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4341 SPRINGDALE HUNTERS RD",
            "city": "SPRINGDALE",
            "state": "WA",
            "postal_code": "991739713",
            "telephone_number": "509-258-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W 5TH AVE",
            "address_2": "SUITE 518",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042823",
            "telephone_number": "509-747-3147",
            "fax_number": "509-747-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHETZEL",
        "first_name": "JANE",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "142619",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8322489",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.