Individual provider Active NPI

Jennifer Coomes, DCN, CDN

  • Metabolic Nutrition Registered Dietitian
  • Sammamish, WA
National Provider Identifier
1952948952
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
DI61564208 Issued in WA
Practice address
22845 SE 1St PL Apt 405
Sammamish, WA 98074-5038
Phone
(425) 505-3090
NPI assigned
Dec 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X DI61564208 WA Primary
Nutritionist 133N00000X NU61007385 WA
Nutrition Education Nutritionist 133NN1002X NU61007385 WA

Addresses

Primary practice location

22845 SE 1St PL Apt 405
Sammamish, WA 98074-5038

Mailing address

22845 SE 1St PL Apt 405
Sammamish, WA 98074-5038
Phone (425) 505-3090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725001577 WA Practitioner - Registered Dietitian Or Nutrition Professional 6204372832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22845 SE 1St PL
Apt 405
Sammamish, WA 98074-5038
Phone (425) 505-3090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NU61007385WAMDNutritionist
DI61564208WAMDMetabolic Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Essence Health and Research Foundation CurrentSince Feb 11, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1952948952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22845 SE 1ST PL APT 405",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980745038",
            "telephone_number": "425-505-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22845 SE 1ST PL APT 405",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980745038",
            "telephone_number": "425-505-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMES",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "DCN, CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "WA",
            "license": "DI61564208",
            "primary": true
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "NU61007385",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "WA",
            "license": "NU61007385",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sammamish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.