Individual provider Active NPI

Jessika Skye Watson

  • School Nurse Practitioner
  • Richland, WA
National Provider Identifier
1639908320
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Nurse PractitionerTaxonomy code 363LS0200X
License
A01124103 Issued in MN
Practice address
780 Swift Blvd
Richland, WA 99352-3524
Phone
(509) 942-3070
Fax
(509) 942-3167
NPI assigned
Jul 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Registered Nurse 163WU0100X RN60761070 WA
School Nurse Practitioner 363LS0200X A01124103 MN Primary

Addresses

Primary practice location

780 Swift Blvd
Richland, WA 99352-3524

Mailing address

500 S College Ave Unit 55
College Place, WA 99324-0902
Phone (509) 540-7759

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250528002947 WA Practitioner - Nurse Practitioner 1951820372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

780 Swift Blvd
Suite 201
Richland, WA 99352-3524
Phone (509) 942-3288

Hospital & facility affiliations

  • Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
  • Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002
  • Lourdes Medical Center Hospital, Pasco, WA, CCN 501337

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A01124103MNMDSchool Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince May 16, 2025 Accepting new patients
Kadlec Regional Medical Center Current Accepting new patients
Kadlec Regional Medical Center CurrentSince May 16, 2025 Accepting new patients

Locations

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

550 Gage Blvd
Ste 101
Richland, WA 99352

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

780 Swift Blvd
Richland, WA 99352
Phone (509) 942-2516

780 Swift Blvd
Ste 201
Richland, WA 99352
Phone (509) 942-3070

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1639908320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S COLLEGE AVE UNIT 55",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993240902",
            "telephone_number": "509-540-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 SWIFT BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523524",
            "telephone_number": "509-942-3070",
            "fax_number": "509-942-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JESSIKA",
        "middle_name": "SKYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WU0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Urology",
            "state": "WA",
            "license": "RN60761070",
            "primary": false
        },
        {
            "code": "363LS0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, School",
            "state": "MN",
            "license": "A01124103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.