NPIMap

Individual provider Active NPI

Jennifer L. Becker, MD

  • Rheumatology Physician
  • Spartanburg, SC
National Provider Identifier
1912129354
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD60795325 Issued in WA
Practice address
853 N Church St
Suite 720a
Spartanburg, SC 29303-3098
Phone
(864) 560-6844
Fax
(864) 560-7015
NPI assigned
May 3, 2007
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 35487 SC
Rheumatology Physician 207RR0500X 49636 CT
Rheumatology Physician 207RR0500X TL35487 SC
Rheumatology Physician 207RR0500X MD60795325 WA Primary

Addresses

Primary practice location

853 N Church St
Suite 720a
Spartanburg, SC 29303-3098

Mailing address

22180 Olympic College Way NW Ste 102
Poulsbo, WA 98370-6664
Phone (360) 779-4444

Other identifiers 3

IdentifierTypeStateIssuer
2094534MedicaidWA
P01194322OtherSCRAILROAD MEDICARE
354878MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbecker267139@fhsce.catholichealth.net Direct

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
I20180313000272 WA Practitioner - RheumatologyPractitioner - Internal Medicine 5395844823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

22180 Olympic College Way NW
Suite 102
Poulsbo, WA 98370-6664
Phone (360) 779-4444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35487SCMDRheumatology Physician
TL35487SCMDRheumatology Physician
MD60795325WAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Mar 5, 2018 Accepting new patients
Franciscan Medical Group CurrentSince Mar 5, 2018 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

22180 Olympic College Way NW
Ste 102
Poulsbo, WA 98370
Phone (360) 779-4444

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: jbecker267139@fhsce.catholichealth.net

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 9

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1912129354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22180 OLYMPIC COLLEGE WAY NW STE 102",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706664",
            "telephone_number": "360-779-4444",
            "fax_number": "253-426-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 N CHURCH ST",
            "address_2": "SUITE 720A",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033098",
            "telephone_number": "864-560-6844",
            "fax_number": "864-560-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "SC",
            "license": "35487",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CT",
            "license": "49636",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "SC",
            "license": "TL35487",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WA",
            "license": "MD60795325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2094534",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01194322",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "354878",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbecker267139@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "22180 Olympic College Way NW Ste 102",
            "city": "Poulsbo",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983706664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.