Individual provider Active NPI

Jordan Vigna

  • Independent Duty Corpsman
  • Port Angeles, WA
National Provider Identifier
1760153316
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
1 Ediz Hook
Port Angeles, WA 98362-2201
Phone
(360) 417-5984
NPI assigned
Sep 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Primary

Addresses

Primary practice location

1 Ediz Hook
Port Angeles, WA 98362-2201

Mailing address

1 Ediz Hook
Port Angeles, WA 98362-2201
Phone (360) 417-5984

Other identifiers 1

IdentifierTypeStateIssuer
1362300750OtherUSCG

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jordan.r.vigna@uscg.mil

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

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1760153316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EDIZ HOOK",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622201",
            "telephone_number": "360-417-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EDIZ HOOK",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622201",
            "telephone_number": "360-417-5984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGNA",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USCG",
            "identifier": "1362300750",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jordan.r.vigna@uscg.mil",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1 Ediz Hook",
            "city": "Port Angeles",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983622201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.