Individual provider Active NPI

Megan Barker

  • Family Nurse Practitioner
  • Bonney Lake, WA
National Provider Identifier
1083080956
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60578734 Issued in WA
Practice address
9230 Sky Island Dr E
Bonney Lake, WA 98391-7385
Phone
(253) 750-6000
NPI assigned
Aug 14, 2015
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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 AP60578734 WA Primary

Addresses

Primary practice location

9230 Sky Island Dr E
Bonney Lake, WA 98391-7385

Mailing address

9230 Sky Island Dr E
Bonney Lake, WA 98391-7385
Phone (253) 750-6000

Other identifiers 1

IdentifierTypeStateIssuer
2047886MedicaidWA

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
I20151014001066 WA Practitioner - Nurse Practitioner 0143539163 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60578734WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eterna Vein & Medical Aesthetics, PLLC CurrentSince Nov 1, 2020 Accepting new patients

Locations

1803 S Meridian
Puyallup, WA 98371
Phone (253) 268-3400

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, 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": "1439510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1083080956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9230 SKY ISLAND DR E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917385",
            "telephone_number": "253-750-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9230 SKY ISLAND DR E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917385",
            "telephone_number": "253-750-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKER",
        "first_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-14",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60578734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2047886",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

Verify at the official NPI Registry.