Individual provider Active NPI

David Ndungu

  • Registered Nurse
  • Lakewood, WA
National Provider Identifier
1083421523
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN61258550 Issued in WA
Practice address
111 Candlewyck Dr W
Lakewood, WA 98499-8113
Phone
(978) 885-7422
Fax
(253) 352-8099
NPI assigned
Dec 17, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X RN61258550 WA Primary

Addresses

Primary practice location

111 Candlewyck Dr W
Lakewood, WA 98499-8113

Mailing address

111 Candlewyck Dr W
Lakewood, WA 98499-8113
Phone (978) 885-7422

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

LicenseStateTypeSpecialty
RN61258550WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Heights Homecare LLC Current Accepting new patients
Daystar Olympia Adult Family Home LLC Registered Nurse CurrentSince Oct 5, 2025 Accepting new patients
American Hearts Homecare LLC Current Accepting new patients
TSS Transportation LLC Current Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1083421523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CANDLEWYCK DR W",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998113",
            "telephone_number": "978-885-7422",
            "fax_number": "253-352-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CANDLEWYCK DR W",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998113",
            "telephone_number": "978-885-7422",
            "fax_number": "253-352-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDUNGU",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61258550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.