Individual provider Active NPI

Juliette Nsubuga

  • Family Nurse Practitioner
  • Renton, WA
National Provider Identifier
1114376613
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP130938 Issued in TX
Practice address
707 S Grady Way Renton Wa 98057
707 S Grady Way Suite 400
Renton, WA 98057-3663
Phone
(972) 206-7087
Fax
(844) 651-3846
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61664202 WA
Family Nurse Practitioner 363LF0000X AP130938 TX Primary

Addresses

Primary practice location

707 S Grady Way Renton Wa 98057
707 S Grady Way Suite 400
Renton, WA 98057-3663

Mailing address

707 S Grady Way Renton Wa 98057
707 S Grady Way Suite 400
Renton, WA 98057-3663
Phone (972) 206-7087

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250604001553 TX Order and Referring Only - Nurse Practitioner 9032495452

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61664202WAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1114376613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S GRADY WAY RENTON WA 98057",
            "address_2": "707 S GRADY WAY SUITE 400",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573663",
            "telephone_number": "972-206-7087",
            "fax_number": "844-651-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S GRADY WAY RENTON WA 98057",
            "address_2": "707 S GRADY WAY SUITE 400",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573663",
            "telephone_number": "972-206-7087",
            "fax_number": "844-651-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NSUBUGA",
        "first_name": "JULIETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2025-04-01",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61664202",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.