NPIMap

Individual provider Active NPI

Erin J Henderson, A.R.N.P.

  • Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1578632527
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30007081 Issued in WA
Practice address
3240 14TH Ave NW
Olympia, WA 98502-8509
Phone
(360) 866-7990
NPI assigned
Nov 6, 2006
Last updated
Apr 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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 AP30007081 WA Primary

Addresses

Primary practice location

3240 14TH Ave NW
Olympia, WA 98502-8509

Mailing address

PO Box 11789
Olympia, WA 98508-1789
Phone (360) 866-7990

Other identifiers 2

IdentifierTypeStateIssuer
9646159MedicaidWA
1013773MedicaidWA

Other names 1

  • Erin J Jenne Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050927001304 WA Practitioner - Nurse Practitioner 5193750362 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vogelgesang, PLLCGroup PAC ID 5991719395, 4 clinicians

Practice addresses (Care Compare)

3240 14TH Ave NW
Olympia, WA 98502-8509
Phone (360) 866-7990

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince May 2, 2016 Accepting new patients
Vogelgesang, PLLC CurrentSince Dec 12, 2012 Accepting new patients
Optum Care Washington PLLC CurrentSince May 2, 2016 Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

4027 Hoyt Ave
Everett, WA 98201
Phone (425) 304-8476

3240 14th Ave NW
Olympia, WA 98502
Phone (360) 491-9480

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

10501 Creek St SE
Ste 2
Yelm, WA 98597
Phone (360) 458-4702

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEAHDD

Organizations & group practices 3

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 9

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1578632527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11789",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985081789",
            "telephone_number": "360-866-7990",
            "fax_number": "360-866-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 14TH AVE NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028509",
            "telephone_number": "360-866-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ERIN",
        "middle_name": "J",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30007081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9646159",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013773",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "JENNE",
            "middle_name": "J",
            "credential": "ARNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.