Individual provider Active NPI

Amanda Marie Jennings, L.M.P

  • Specialist
  • Bellevue, WA
National Provider Identifier
1558636589
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA60229213 Issued in WA
Practice address
12015 NE 8TH St
Suite 1
Bellevue, WA 98005-3141
Phone
(425) 451-4465
Fax
(425) 462-4247
NPI assigned
Mar 8, 2012
Last updated
Mar 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA60229213 WA Primary

Addresses

Primary practice location

12015 NE 8TH St
Suite 1
Bellevue, WA 98005-3141

Mailing address

12015 North East 8TH Street
Suite 1
Bellevue, WA 98005
Phone (425) 451-4465

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
MA60229213WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Nu Star Chiropractors of NW, Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1558636589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12015 NORTH EAST 8TH STREET",
            "address_2": "SUITE 1",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "425-451-4465",
            "fax_number": "425-462-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12015 NE 8TH ST",
            "address_2": "SUITE 1",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053141",
            "telephone_number": "425-451-4465",
            "fax_number": "425-462-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "L.M.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60229213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.