Heather F Jennings, CG

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

CG60803732 Issued in WA

Practice address

165 E Hawthorne Ave
Colville, WA 99114-2629

Phone

(509) 684-4597

Fax

(509) 684-5286

NPI assigned

Nov 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Heather F Meddaugh Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Stevens County

  • Mental Illness Community Based Residential Treatment Facility
  • Colville, WA
  • NPI 1922517192
  NPD (past)

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1942777487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 E HAWTHORNE AVE",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142629",
            "telephone_number": "509-684-4597",
            "fax_number": "509-684-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E HAWTHORNE AVE",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142629",
            "telephone_number": "509-684-4597",
            "fax_number": "509-684-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "HEATHER",
        "middle_name": "F",
        "credential": "CG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "WA",
            "license": "CG60803732",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "CG60803732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "MEDDAUGH",
            "middle_name": "F",
            "credential": "CG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carol E Jackson
• Christopher M Jackson
• Daniel W James
• Sandra K James, PAC
• Linzi G Jeleniowski, LPN
• Renee M. Jennings
• Jo Nell R Amburgey, MSW, Licsw
• Carol Eileen Johansen
• Michael Jay John, RN
• Jenna B Johnson, MSW

• Student in an Organized Health Care Education/Training Program in Colville, WA
• Providers in Colville, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.