NPIMap

Individual provider Active NPI

Nicole Jeffery, MD

  • Family Medicine Physician
  • Bethel, AK
National Provider Identifier
1992333405
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200765 Issued in AK
Practice address
700 Chief Eddie Hoffman Hwy
Bethel, AK 99559
Phone
(907) 543-6300
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200765 AK Primary

Addresses

Primary practice location

700 Chief Eddie Hoffman Hwy
Bethel, AK 99559

Mailing address

PO Box 2947
Bethel, AK 99559-2947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200765AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services PastSince Apr 1, 2020 Accepting new patients
Yukon-Kuskokwim Health Corporation Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/663c4c6d-1396-44a4-b589-c11a968d4876/
  • Direct secure messaging: njeffery1254582@wm.providencedirect.org

Organizations & group practices 2

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1992333405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2947",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "995592947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHIEF EDDIE HOFFMAN HWY",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "99559",
            "telephone_number": "907-543-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERY",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "200765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.