NPIMap

Organization Active NPI

Bywater Medical Consultants PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Mount Vernon, WA
National Provider Identifier
1033347422
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP30007181 Issued in WA
Legal business name
BYWATER MEDICAL CONSULTANTS PLLC
Practice address
1911 E Division St
Mount Vernon, WA 98274-6703
Phone
(360) 708-9741
Fax
(360) 588-4192
NPI assigned
Jun 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Authorized official

Name
Elizabeth M. Holmes, ARNP
Title
Owner
Phone
(360) 708-9741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X AP30007181 WA Primary

Addresses

Primary practice location

1911 E Division St
Mount Vernon, WA 98274-6703

Mailing address

PO Box 1627
Mount Vernon, WA 98273-1627
Phone (360) 708-9741

Other practice location 1

721 S 1st St
Mount Vernon, WA 98273-3812
Phone (360) 708-9741

Other names 1

  • Bywater Psychiatric Consultation Former legal business name

National Provider Directory

National Provider Directory

Locations

1911 E Division St
Mount Vernon, WA 98274
Phone (360) 708-9741

721 S 1st St
Mount Vernon, WA 98273
Phone (360) 708-9741

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586131200000",
    "number": "1033347422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1627",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982731627",
            "telephone_number": "360-708-9741",
            "fax_number": "801-780-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 E DIVISION ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982746703",
            "telephone_number": "360-708-9741",
            "fax_number": "360-588-4192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 S 1st St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982733812",
            "country_code": "US",
            "telephone_number": "360-708-9741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BYWATER MEDICAL CONSULTANTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-24",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-708-9741",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30007181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bywater Psychiatric Consultation",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Bywater Psychiatric Consultation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; 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.