Individual provider Active NPI

Andrea Paulina Munoz Vargas, LPN

  • Licensed Practical Nurse
  • Wenatchee, WA
National Provider Identifier
1104487313
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP60883082 Issued in WA
Practice address
1320 Monitor St
Wenatchee, WA 98801-3536
Phone
(509) 300-1221
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP60883082 WA Primary

Addresses

Primary practice location

1320 Monitor St
Wenatchee, WA 98801-3536

Mailing address

12715 E Mission Ave
Spokane Valley, WA 99216-1027
Phone (509) 232-5766

Other identifiers 1

IdentifierTypeStateIssuer
2077844MedicaidWA

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
LP60883082WAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
American Behavioral Health Systems, Inc. Past Accepting new patients
American Behavioral Health Systems, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1104487313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12715 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161027",
            "telephone_number": "509-232-5766",
            "fax_number": "509-321-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MONITOR ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013536",
            "telephone_number": "509-300-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ VARGAS",
        "first_name": "ANDREA",
        "middle_name": "PAULINA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP60883082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2077844",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.