NPIMap

Individual provider Active NPI

Jamie Lane Nixon, PA-C

  • Physician Assistant
  • Olympia, WA
National Provider Identifier
1619060431
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10005075 Issued in WA
Practice address
403 Black Hills LN SW Ste B
Olympia, WA 98502-8600
Phone
(360) 709-9500
Fax
(360) 754-4517
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10005075 WA Primary

Addresses

Primary practice location

403 Black Hills LN SW Ste B
Olympia, WA 98502-8600

Mailing address

403 Black Hills LN SW Ste B
Olympia, WA 98502-8600
Phone (360) 709-9500

Other identifiers 2

IdentifierTypeStateIssuer
P00346592OtherRAILROAD MEDICARE
8464158MedicaidWA

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
I20061113000076 WA Practitioner - Physician Assistant 0547268229 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1217 Cooper Point Rd SW
Suite 2
Olympia, WA 98502-7204
Phone (360) 569-9690

3920 Capital Mall Dr SW
Suite 200
Olympia, WA 98502-8701
Phone (360) 459-7282

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Apr 29, 2021 Accepting new patients
Capital Medical Center Physicians LLC CurrentSince Dec 24, 2017 Accepting new patients
Multicare Health System CurrentSince Apr 29, 2021 Accepting new patients
Lewis County Community Health Services Past Accepting new patients
South Sound Family & Sports Past Accepting new patients
South Sound Health & Fitness Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

2960 Limited Ln NW
Ste A
Olympia, WA 98502
Phone (360) 705-0279

3920 Capital Mall Dr SW
Ste 200
Olympia, WA 98502
Phone (360) 459-7282

403 Black Hills Ln SW
Ste B
Olympia, WA 98502
Phone (360) 709-9500

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

Interoperability endpoints

  • Direct secure messaging: jamie.nixon.2@2876.direct.athenahealth.com

Organizations & group practices 9

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.

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1619060431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 BLACK HILLS LN SW STE B",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028600",
            "telephone_number": "360-709-9500",
            "fax_number": "360-754-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 BLACK HILLS LN SW STE B",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028600",
            "telephone_number": "360-709-9500",
            "fax_number": "360-754-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIXON",
        "first_name": "JAMIE",
        "middle_name": "LANE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-03-07",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00346592",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8464158",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.