Individual provider Active NPI

Jacob Charles Deakins, MD

  • Family Medicine Physician
  • Spokane, WA
National Provider Identifier
1760639603
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60078644 Issued in WA
Practice address
551 E Hawthorne Rd
Spokane, WA 99218-1417
Phone
(509) 489-2369
Fax
(509) 227-7070
NPI assigned
Aug 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1038 WY
Family Medicine Physician 207Q00000X MD60078644 WA Primary

Addresses

Primary practice location

551 E Hawthorne Rd
Spokane, WA 99218-1417

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other identifiers 1

IdentifierTypeStateIssuer
8547978MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdeakins229864@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090813000601 WA Practitioner - Family Practice 1951454339 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1038WYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 Current Accepting new patients
Doctors Clinic of Spokane Family Medicine Past Accepting new patients

Locations

411 Fortuyn Rd
Grand Coulee, WA 99133
Phone (509) 633-1753

101 W 8th Ave
Ste 100
Spokane, WA 99204
Phone (509) 474-2880

101 W 8th Ave
Fl 3
Spokane, WA 99204
Phone (509) 474-2277

16528 E Desmet Ct
Spokane Valley, WA 99216
Phone (509) 944-8910

Interoperability endpoints

  • Direct secure messaging: jdeakins229864@wm.providencedirect.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1760639603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 E HAWTHORNE RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181417",
            "telephone_number": "509-489-2369",
            "fax_number": "509-227-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAKINS",
        "first_name": "JACOB",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-22",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "1038",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60078644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8547978",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdeakins229864@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "551 E Hawthorne Rd",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992181417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.