Individual provider Active NPI

Jennifer L Bayer, PHD

  • Psychologist
  • Bellingham, WA
National Provider Identifier
1972069029
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY60902082 Issued in WA
Practice address
1140 10TH St Ste 203
Bellingham, WA 98225-7053
Phone
(360) 319-9930
NPI assigned
Feb 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X NU60176199 WA
Psychologist 103T00000X PY60902082 WA Primary

Addresses

Primary practice location

1140 10TH St Ste 203
Bellingham, WA 98225-7053

Mailing address

1140 10TH St Ste 203
Bellingham, WA 98225-7053
Phone (360) 319-9930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190701001973 WA Practitioner - Clinical Psychologist 2062746688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Iowa, RJ & L Carver College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1855 Main St
Suite 208
Ferndale, WA 98248-9060
Phone (360) 319-9930

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY60902082WAMDPsychologist
NU60176199WAMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
A Rooted Life Psychotherapy PLLC Psychologist CurrentSince Mar 1, 2019 Accepting new patients

Locations

1140 10th St
Ste 203
Bellingham, WA 98225
Phone (360) 319-9930

1855 Main St
Ste 208
Ferndale, WA 98248
Phone (360) 319-9930

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": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1972069029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 10TH ST STE 203",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257053",
            "telephone_number": "360-319-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 10TH ST STE 203",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257053",
            "telephone_number": "360-319-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYER",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "WA",
            "license": "NU60176199",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60902082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.