NPIMap

Organization Active NPI

Leyton Endicott Jump

Doing business as Tenino Family Practice

  • Family Medicine Physician
  • Tenino, WA
National Provider Identifier
1851357008
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00022762 Issued in WA
Legal business name
LEYTON ENDICOTT JUMP
Doing business as
Tenino Family Practice
Practice address
273 Sussex Ave E
Tenino, WA 98589-9359
Phone
(360) 264-5665
Fax
(360) 264-5666
NPI assigned
Apr 25, 2006
Last updated
Jun 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Authorized official

Name
Dr. Leyton Endicott Jump, MDNPI 1790741924
Title
Owner
Phone
(360) 264-5665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00022762 WA Primary

Addresses

Primary practice location

273 Sussex Ave E
Tenino, WA 98589-9359

Mailing address

PO Box 4020
Tenino, WA 98589-4020
Phone (360) 264-5665

Other identifiers 2

IdentifierTypeStateIssuer
7102478MedicaidWA
122559OtherWALABOR & INDUSTRIES

Other names 1

  • Tenino Family Practice Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370304000000",
    "number": "1851357008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4020",
            "city": "TENINO",
            "state": "WA",
            "postal_code": "985894020",
            "telephone_number": "360-264-5665",
            "fax_number": "360-264-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 SUSSEX AVE E",
            "city": "TENINO",
            "state": "WA",
            "postal_code": "985899359",
            "telephone_number": "360-264-5665",
            "fax_number": "360-264-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEYTON ENDICOTT JUMP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2013-06-04",
        "status": "A",
        "authorized_official_last_name": "JUMP",
        "authorized_official_first_name": "LEYTON",
        "authorized_official_middle_name": "ENDICOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-264-5665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00022762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7102478",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "122559",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tenino Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tenino, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.