Individual provider Active NPI

Jacob Harwood

  • Case Manager/Care Coordinator
  • Yakima, WA
National Provider Identifier
1740421239
Registry record updated Apr 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
407 S 25TH Ave
Yakima, WA 98902-3706
Phone
(509) 969-0538
NPI assigned
Mar 13, 2009
Last updated
Apr 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X RC60083835 WA
Case Manager/Care Coordinator 171M00000X WA Primary

Addresses

Primary practice location

407 S 25TH Ave
Yakima, WA 98902-3706

Mailing address

407 S 25TH Ave
Yakima, WA 98902-3706
Phone (509) 969-0538

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

LicenseStateTypeSpecialty
RC60083835WAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271635200000",
    "number": "1740421239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S 25TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023706",
            "telephone_number": "509-969-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S 25TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023706",
            "telephone_number": "509-969-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARWOOD",
        "first_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-13",
        "last_updated": "2010-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC60083835",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.