Individual provider Active NPI

Jessica R Maike

  • Acute Care Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1841701752
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP60903621 Issued in WA
Practice address
413 Lilly Rd NE
Olympia, WA 98506-5133
Phone
(360) 493-4083
NPI assigned
Oct 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP60903621 WA Primary

Addresses

Primary practice location

413 Lilly Rd NE
Olympia, WA 98506-5133

Mailing address

PO Box 3360
Portland, OR 97208-3360

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmaike977934@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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190212002082 WA Practitioner - Nurse Practitioner 3779821079 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Medical Specialties PLLCGroup PAC ID 8022903384, 37 clinicians

Practice addresses (Care Compare)

1624 I St S
Suite 305
Tacoma, WA 98405-5093

1624 S I St
Tacoma, WA 98405-5093
Phone (253) 428-8700

2940 S Meridian
Suite 200
Puyallup, WA 98373-1659
Phone (253) 428-8700

Hospital & facility affiliations

  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC CurrentSince Apr 18, 2023 Accepting new patients
Cogent Healthcare of Washington, PC CurrentSince Jan 1, 2022 Accepting new patients
Providence Health & Services Washington CurrentSince Nov 1, 2018 Accepting new patients
Providence Health & Services Washington CurrentSince Nov 1, 2018 Accepting new patients
Northwest Medical Specialties PLLC CurrentSince Nov 7, 2022 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Providence Health & Services Washington CurrentSince Nov 1, 2018 Accepting new patients
Comprehensive Postacute Care PLLC CurrentSince Jul 22, 2020 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Apr 18, 2023 Accepting new patients
Northwest Medical Specialties Pharmacy Past Accepting new patients

Locations

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

3920 Capital Mall Dr SW
Ste 402
Olympia, WA 98502
Phone (360) 704-4786

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2940 S Meridian
Ste 200
Puyallup, WA 98373

2920 S Meridian
Ste 100
Puyallup, WA 98373
Phone (253) 604-4599

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

1624 S I St
Ste 102
Tacoma, WA 98405
Phone (253) 383-3366

1624 S I St
Ste 305
Tacoma, WA 98405

Organizations & group practices 10

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": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1841701752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133",
            "telephone_number": "360-493-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIKE",
        "first_name": "JESSICA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP60903621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmaike977934@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "413 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.