Active NPI
Jodi C Negrete, LMP
- Specialist
- Olympia, WA
National Provider Identifier
1679637003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00020160
- Practice address
- 1025 Black Lake Blvd SW
Olympia, WA 98502-1120 - Phone
- (360) 402-6284
- NPI assigned
- Dec 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | MA00020160 | WA | Primary |
Addresses
Primary practice location
1025 Black Lake Blvd SW
Olympia, WA 98502-1120
Mailing address
3906 Cooper Crest Dr NW
Olympia, WA 98502-4071
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA00020160 | Other | WA | LMP |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00020160 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208304000000",
"number": "1679637003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3906 COOPER CREST DR NW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985024071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 BLACK LAKE BLVD SW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985021120",
"telephone_number": "360-402-6284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEGRETE",
"first_name": "JODI",
"middle_name": "C",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-20",
"last_updated": "2008-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00020160",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMP",
"identifier": "MA00020160",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.