Active NPI
Jennifer Elliott
- Registered Nurse
- Tacoma, WA
National Provider Identifier
1992363485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 2012019514
- Practice address
- Madigan Army Medical Center Attn: MCHJ-CLQ-C
Tacoma, WA 98431-0001 - Phone
- (253) 968-0982
- NPI assigned
- May 30, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2012019514 | MO | Primary |
Addresses
Primary practice location
Madigan Army Medical Center Attn: MCHJ-CLQ-C
Tacoma, WA 98431-0001
Mailing address
PO Box 1312
Rolla, MO 65402-1312
Phone (573) 647-1986
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012019514 | MO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559174400000",
"number": "1992363485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1312",
"city": "ROLLA",
"state": "MO",
"postal_code": "654021312",
"telephone_number": "573-647-1986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MADIGAN ARMY MEDICAL CENTER ATTN: MCHJ-CLQ-C",
"city": "TACOMA",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "253-968-0982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-30",
"last_updated": "2019-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2012019514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.