Jake Lee Jennings, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT61020340 Issued in WA

Practice address

1711 Dalles Military Rd
Walla Walla, WA 99362-8028

Phone

(509) 529-3220

NPI assigned

Jan 22, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjennings4264919@ghc.direct-ci.net

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1740810340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LOCHER RD",
            "city": "TOUCHET",
            "state": "WA",
            "postal_code": "993609648",
            "telephone_number": "509-593-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 DALLES MILITARY RD",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993628028",
            "telephone_number": "509-529-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "JAKE",
        "middle_name": "LEE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": "PT61020340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Marie Jackson, RN
• Whitney Kathleen Jacky, AU.D.
• Jamie M Coleman MD
• Eric J Jauhiainen, M.D.
• Christopher K Jenkins, DO
• Melanie Anne Jensen
• Adonai Jerez, RN
• Jmwmva Medical Center
• Christina R Johanson, MPT
• John Anton Fackenthall

• Orthopedic Physical Therapist in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Orthopedic Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.