Individual provider Active NPI

Jennifer Kooiker Benson, MD

  • Family Medicine Physician
  • Mount Vernon, WA
National Provider Identifier
1801899182
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00037772 Issued in WA
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

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

819 S 13TH St
Mount Vernon, WA 98274-4112
Phone (360) 814-6230

Hospital & facility affiliations

  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Aug 1, 2016 Accepting new patients
Public Hospital Dist No 1 Skagit Family Medicine CurrentSince Aug 1, 2016 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.