Jennifer Lee Bomberger

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60650503 Issued in WA

Practice address

915 S Columbus Ave
Goldendale, WA 98620-9068

Phone

(541) 910-2932

NPI assigned

Jun 12, 2012

Last updated

Dec 14, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Klickitat County Public Hospital District No 1Group PAC ID 0648164269, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Klickitat County Public Hospital District No 1

  dba KVH Family Medicine

  • Clinic/Center
  • Goldendale, WA
  • NPI 1467530915
  Medicare reassignment Care Compare group NPD
• Klickitat County Public Hospital District No 1

  dba Klickitat Valley Hospital

  • Emergency Care Clinic/Center
  • Goldendale, WA
  • NPI 1780754507
  NPD
• Klickitat County Public Hospital District No 1

  dba KVH Family Medicine

  • Rural Health Clinic/Center
  • Goldendale, WA
  • NPI 1407952369
  NPD (past)

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1871855221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 ALLISON WAY",
            "city": "GOLDENDALE",
            "state": "WA",
            "postal_code": "986209231",
            "telephone_number": "541-910-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 S COLUMBUS AVE",
            "city": "GOLDENDALE",
            "state": "WA",
            "postal_code": "986209068",
            "telephone_number": "541-910-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBERGER",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60650503",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penny Andress, RN, BSN
• Nathan Christian Armerding, D.O.
• Jeannette Dorothy Baars, PA-C
• Tawna L Barck, PA
• Donna Jane Beierle-Brown, MASSAGE THERAPY
• Konstantine E Bunde, D.C.
• Emmelia Colleen Marie Cappelletti
• Lorri E Carr, LM, CPM, LDM
• Lori Lyn Carsey, LMP
• Dennis L Carver, DC

• Mental Health Counselor in Goldendale, WA
• Providers in Goldendale, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.