Individual provider Active NPI

Jessica Lyn Taylor, ARNP-C

  • Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1851069538
Registry record updated Oct 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP61226463 Issued in WA
Practice address
Madiagn Army Medical Center 9040 Jackson Avenue
Tacoma, WA 98431-1200
Phone
(865) 567-3530
NPI assigned
Aug 30, 2021
Last updated
Oct 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP61226463 WA Primary
Family Nurse Practitioner 363LF0000X 61042185 WA

Addresses

Primary practice location

Madiagn Army Medical Center 9040 Jackson Avenue
Tacoma, WA 98431-1200

Mailing address

690 Barnes Blvd
Joint Base Lewis McChord, WA 98438-1303
Phone (253) 982-2222

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
I20211108002898 WA Practitioner - Nurse Practitioner 1355730607 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Olympia Multi Specialty ClinicGroup PAC ID 4789571092, 21 clinicians

Practice addresses (Care Compare)

406 Black Hills LN SW
Suite a
Olympia, WA 98502-8144
Phone (360) 754-1727

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61226463WAMDNurse Practitioner
61042185WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maksportsmd CurrentSince Oct 29, 2021 Accepting new patients
Olympia Pediatrics, PLLC Past Accepting new patients
Therapy Management Services, PLLC PastSince Oct 29, 2021 Accepting new patients

Locations

19110 Bothell Way NE
Ste 102
Bothell, WA 98011
Phone (253) 268-2200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729987200000",
    "number": "1851069538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 BARNES BLVD",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984381303",
            "telephone_number": "253-982-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIAGN ARMY MEDICAL CENTER 9040 JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311200",
            "telephone_number": "865-567-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JESSICA",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "ARNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2024-10-27",
        "certification_date": "2024-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61226463",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "61042185",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.