Active NPI
Douglas L. Jennings, D.O.
- Anesthesiology Physician
- Bremerton, WA
National Provider Identifier
1649278037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- OP00001360
- Practice address
- 990 Sylvan Way
Bremerton, WA 98310-2851 - Phone
- (360) 479-3657
- Fax
- (360) 373-7616
- NPI assigned
- Jul 11, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | OP00001360 | WA | Primary |
Addresses
Primary practice location
990 Sylvan Way
Bremerton, WA 98310-2851
Mailing address
990 Sylvan Way
Bremerton, WA 98310-2851
Phone (360) 479-3657
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016487001 | Other | WA | GROUP HEALTH CORP |
| 79703 | Other | WA | LABOR AND INDUSTRIES |
| 8934065 | Other | WA | VICTIMS OF CRIME |
| 910847215 | Other | WA | UNIFORM MEDICAL |
| 910847215 | Other | WA | PREMERA BLUE CROSS |
| 91084721523 | Other | WA | KPS |
| 050020529 | Other | WA | RAILROAD MEDICARE |
| JE7215 | Other | WA | REGENCE BLUE SHIELD |
| 8137572 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP00001360 | WA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232496000000",
"number": "1649278037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 SYLVAN WAY",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983102851",
"telephone_number": "360-479-3657",
"fax_number": "360-373-7616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 SYLVAN WAY",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983102851",
"telephone_number": "360-479-3657",
"fax_number": "360-373-7616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "DOUGLAS",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-11",
"last_updated": "2009-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WA",
"license": "OP00001360",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH CORP",
"identifier": "016487001",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRIES",
"identifier": "79703",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VICTIMS OF CRIME",
"identifier": "8934065",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIFORM MEDICAL",
"identifier": "910847215",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREMERA BLUE CROSS",
"identifier": "910847215",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KPS",
"identifier": "91084721523",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "050020529",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "JE7215",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8137572",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.