Audris Korth, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP61375441 Issued in WA

Practice address

3510 57TH Ave NW
Gig Harbor, WA 98335-7214

Phone

(360) 990-1144

NPI assigned

Apr 12, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 5, 2024 through Mar 5, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• P3 Healthcare

  • Primary Care Clinic/Center
  • Puyallup, WA
  • NPI 1639054075
  NPD (past)

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1083300149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 57TH AVE NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983357214",
            "telephone_number": "360-990-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 57TH AVE NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983357214",
            "telephone_number": "360-990-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTH",
        "first_name": "AUDRIS",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61375441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Michelle Knutzen, M.S.
• Monica Koch, IHP
• Alison Komomua, RN
• Sarah A Konecny, PA-C
• Stephanie Lynn Kornechuk, PHARMD
• Andrea Kouneev, MA, LMHC, NCC, OTR/L
• Lois E Kramer, MS,OTR/L
• Mariel Castaneda Kraus, OTR/L
• Samantha Jo Krieg, DC
• Molly Susan Krook, PHARMD

• Nurse Practitioner in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.