Active NPI
Jennifer Kooiker Benson, MD
- Family Medicine Physician
- Mount Vernon, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD00037772
- Practice address
- 110 N Laventure Rd Ste C
Mount Vernon, WA 98273-3901 - Phone
- (360) 399-7700
- Fax
- (360) 899-4534
- NPI assigned
- May 31, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00037772 | WA | Primary |
Addresses
Primary practice location
110 N Laventure Rd Ste C
Mount Vernon, WA 98273-3901
Mailing address
1400 E Kincaid St
Mount Vernon, WA 98274-4127
Other names 1
- Jennifer R Kooiker
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jbenson15599@skagit.direct-ci.com | 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050404000913 | WA | Practitioner - Family Practice | 9335196112 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Washington School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
819 S 13TH St
Mount Vernon, WA 98274-4112
Phone (360) 814-6230
Hospital & facility affiliations
- Skagit Valley Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Public Hospital Dist No 1 Skagit | Current | Accepting new patients | |
| Public Hospital Dist No 1 Skagit | Current | Accepting new patients | |
| Public Hospital Dist No 1 Skagit | Family Medicine | Current | Accepting new patients |
| Public Hospital Dist No 1 Skagit | Past | Accepting new patients |
Locations
3823 172nd St NE
Arlington, WA 98223
Phone (360) 618-5000
1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586
819 S 13th St
Mount Vernon, WA 98274
Phone (360) 336-9757
901 S 5th St
Mount Vernon, WA 98274
Phone (360) 428-6434
2320 Freeway Dr
Mount Vernon, WA 98273
Phone (360) 814-6800
110 N Laventure Rd
Ste C
Mount Vernon, WA 98273
Phone (360) 399-7700
Organizations & group practices 4
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.
-
- Rural Health Clinic/Center
- Darrington, WA
- NPI 1013064575
Family Medicine
-
- Physical Therapist
- Mount Vernon, WA
- NPI 1811460652
-
- Specialist
- Mount Vernon, WA
- NPI 1629012463
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mount Vernon, WA
- NPI 1053357244
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1801899182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 E KINCAID ST",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982744127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 N LAVENTURE RD STE C",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982733901",
"telephone_number": "360-399-7700",
"fax_number": "360-899-4534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENSON",
"first_name": "JENNIFER",
"middle_name": "KOOIKER",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-31",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD00037772",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jbenson15599@skagit.direct-ci.com",
"affiliation": "N",
"endpointDescription": "Provider Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "110 N Laventure Rd Ste C",
"city": "Mount Vernon",
"state": "WA",
"country_code": "US",
"postal_code": "982733901",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "KOOIKER",
"middle_name": "R",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Mount Vernon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.