NPIMap

Individual provider Active NPI

Jennifer W Flannery, PA-C

  • Physician Assistant
  • Aberdeen, WA
National Provider Identifier
1881633477
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004754 Issued in WA
Practice address
915 Anderson Dr
Aberdeen, WA 98520-1006
Phone
(360) 537-6113
Fax
(360) 537-6146
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10004754 WA Primary

Addresses

Primary practice location

915 Anderson Dr
Aberdeen, WA 98520-1006

Mailing address

1006 N H St
Aberdeen, WA 98520-2535
Phone (360) 537-6113

Other identifiers 1

IdentifierTypeStateIssuer
8500126MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050725000042 WA Practitioner - Physician Assistant 8224065032 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

1550 N 115TH St
Seattle, WA 98133-8401
Phone (206) 364-0500

1570 N 115TH St
Seattle, WA 98133-8401
Phone (206) 306-2800

1701 Columbia Rd
Seattle, WA 98195-0001
Phone (206) 598-3100

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

Hospital & facility affiliations

  • Fred Hutchinson Cancer Center Hospital, Seattle, WA, CCN 500138
  • University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072
  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor Community Hospital CurrentSince Apr 11, 2005 Accepting new patients
Grays Harbor Community Hospital CurrentSince Apr 11, 2005 Accepting new patients
Overlake Medical Clinics, LLC Past Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 532-8330

1006 N H St
Aberdeen, WA 98520
Phone (360) 537-6032

Organizations & group practices 8

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 6

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881633477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 N H ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985202535",
            "telephone_number": "360-537-6113",
            "fax_number": "360-537-6146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 ANDERSON DR",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201006",
            "telephone_number": "360-537-6113",
            "fax_number": "360-537-6146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANNERY",
        "first_name": "JENNIFER",
        "middle_name": "W",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8500126",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

Verify at the official NPI Registry.