Individual provider Active NPI

Jennifer Emily Boyd, LMP

  • Contractor
  • Kingston, WA
National Provider Identifier
1902163215
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
MA60265601 Issued in WA
Practice address
26659 Myrtle LN NE Apt 102
Kingston, WA 98346-9464
Phone
(360) 516-0743
NPI assigned
Apr 12, 2012
Last updated
Apr 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X MA60265601 WA Primary

Addresses

Primary practice location

26659 Myrtle LN NE Apt 102
Kingston, WA 98346-9464

Mailing address

26659 Myrtle Lane NE Apt.102
Kingston, WA 98346
Phone (360) 516-0743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA60265601WAMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1902163215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26659 MYRTLE LANE NE APT.102",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "98346",
            "telephone_number": "360-516-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26659 MYRTLE LN NE APT 102",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983469464",
            "telephone_number": "360-516-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "JENNIFER",
        "middle_name": "EMILY",
        "name_prefix": "Ms.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "WA",
            "license": "MA60265601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.