Individual provider Active NPI

Kim D. Jewell, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Vancouver, WA
National Provider Identifier
1982727608
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD00045019 Issued in WA
Practice address
700 NE 87TH Ave # 350
Vancouver, WA 98664-1913
Phone
(360) 882-2778
Fax
(360) 604-1724
NPI assigned
Apr 9, 2007
Last updated
Nov 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X A94841 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD00045019 WA Primary

Addresses

Primary practice location

700 NE 87TH Ave # 350
Vancouver, WA 98664-1913

Mailing address

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141222000837 WA Practitioner - Pathology 4284734450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Washington School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94841CAMDMarriage & Family Therapist
MD00045019WAMDAnatomic Pathology & Clinical Pathology Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1982727608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE # 350",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641913",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "KIM",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CA",
            "license": "A94841",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD00045019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.