Jennifer Shannon Niemi, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60209815 Issued in WA

Practice address

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748

Phone

(425) 563-1500

Fax

(425) 563-1501

NPI assigned

Apr 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054
• Providence Mount Carmel Hospital Hospital, Colville, WA, CCN 501326
• Providence St Joseph Hospital Hospital, Chewelah, WA, CCN 501309

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jniemi327412@wm.providencedirect.org

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.

• Providence Health & Services Washington

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Washington

  • General Practice Physician
  • Spokane, WA
  • NPI 1306391446
  NPD

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

• Providence Health & Services - Wa

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation
• Providence Health & Services - Wa

  • Critical Access Hospital
  • Chewelah, WA
  • NPI 1750532321
  Care Compare affiliation
• Providence Health & Services - Washington

  • Critical Access Hospital
  • Colville, WA
  • NPI 1003067679
  Care Compare affiliation

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1598054249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21700 Highway 99",
            "address_purpose": "LOCATION",
            "city": "Edmonds",
            "state": "WA",
            "postal_code": "980268034",
            "country_code": "US",
            "telephone_number": "425-640-4949",
            "fax_number": "425-640-4940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8301 161st Ave NE Ste 104",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980523858",
            "country_code": "US",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11521 NE 128th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980344317",
            "country_code": "US",
            "telephone_number": "425-952-6100",
            "fax_number": "425-952-6150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEMI",
        "first_name": "JENNIFER",
        "middle_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "22832A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60209815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021864",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nichole C. Martin, D.M.D., PLLC
• Brenden Taylor Nichols, PT
• Loriann Nichols, LPN
• Ashley Marie Nicklin, LMP
• Kristina Nielsen
• Keyvan Dastkhosh Nikghalb I
• Erin Nilsen
• Damaris Njenga
• Bridget Noorishad, ARNP
• Nordstrom Inc & Subsidiaries

• Family Nurse Practitioner in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.