NPIMap

Individual provider Active NPI

Jordan Rafter, ARNP

  • Nurse Practitioner
  • Spokane Valley, WA
National Provider Identifier
1760929160
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP 60703568 Issued in WA
Practice address
12606 E Mission Ave
Spokane Valley, WA 99216-3421
Phone
(509) 924-6650
NPI assigned
Jan 23, 2017
Last updated
Jan 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP 60703568 WA Primary

Addresses

Primary practice location

12606 E Mission Ave
Spokane Valley, WA 99216-3421

Mailing address

3227 N Washington St
Spokane, WA 99205-4917
Phone (509) 638-7968

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828003780 WA Order and Referring Only - Nurse Practitioner 5092099697

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP 60703568WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Health Services Past Accepting new patients
Sullivan SNF Healthcare LLC Past Accepting new patients
Care Center (Sullivan Park) Inc Past Accepting new patients
Multicare Health System Past Accepting new patients
Avalon Care Center - Spokane LLC Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1760929160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3227 N WASHINGTON ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992054917",
            "telephone_number": "509-638-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12606 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992163421",
            "telephone_number": "509-924-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFTER",
        "first_name": "JORDAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP 60703568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.