Individual provider Active NPI

Jessica Anne Ivers, M.D.

  • Pediatrics Physician
  • Seattle, WA
National Provider Identifier
1831414077
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
60358068 Issued in WA
Practice address
4744 41St Ave SW Ste 101
Seattle, WA 98116-4566
Phone
(206) 320-5780
Fax
(206) 320-5794
NPI assigned
Mar 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60358068 WA Primary

Addresses

Primary practice location

4744 41St Ave SW Ste 101
Seattle, WA 98116-4566

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other names 1

  • Jessica Anne Lichter Former name

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
I20150811004916 WA Practitioner - Pediatric Medicine 7416262001 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60358068WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Pediatrics CurrentSince Feb 5, 2024 Accepting new patients
Swedish Health Services CurrentSince Feb 5, 2024 Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

4744 41st Ave SW
Ste 101
Seattle, WA 98116
Phone (206) 320-5780

4100 SW Alaska St
#B
Seattle, WA 98116
Phone (206) 320-3399

Interoperability endpoints

  • Direct secure messaging: jivers1068305@wm.providencedirect.org

Organizations & group practices 2

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": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1831414077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4744 41ST AVE SW STE 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164566",
            "telephone_number": "206-320-5780",
            "fax_number": "206-320-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERS",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "60358068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LICHTER",
            "middle_name": "ANNE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.