Individual provider Active NPI

Michael C Charles, ARNP

  • Family Nurse Practitioner
  • Lakewood, WA
National Provider Identifier
1063603314
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30007816 Issued in WA
Practice address
5700 100TH St SW
Lakewood, WA 98499-2752
Phone
(253) 584-2119
NPI assigned
Aug 1, 2007
Last updated
Mar 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP30007816 WA Primary

Addresses

Primary practice location

5700 100TH St SW
Lakewood, WA 98499-2752

Mailing address

5700 100TH St SW
Lakewood, WA 98499-2752
Phone (253) 584-2119

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071031000184 WA Practitioner - Nurse Practitioner 1254428758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

3928 Pacific Ave SE
Lacey, WA 98503-1109
Phone (360) 455-1350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30007816WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Washington, P.S. Current Accepting new patients
Multicare Health System CurrentSince Jul 7, 2008 Accepting new patients
Multicare Health System CurrentSince Jul 7, 2008 Accepting new patients
Multicare Health System Current Accepting new patients
American Current Care of Washington, P.S. CurrentSince Nov 12, 2018 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

1925 140th Ave NE
Bellevue, WA 98005
Phone (425) 865-8060

3101 111th St SW
Unit Tu
Everett, WA 98204
Phone (425) 267-0299

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

3928 Pacific Ave SE
Olympia, WA 98503
Phone (360) 413-8700

9222 N Newport Hwy
Ste 1
Spokane, WA 99218
Phone (509) 467-4545

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 6

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": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1063603314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 100TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992752",
            "telephone_number": "253-584-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 100TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992752",
            "telephone_number": "253-584-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30007816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.