Individual provider Active NPI

Bernard Mwangi, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1124803192
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61478064 Issued in WA
Practice address
104 W 5TH Ave
Spokane, WA 99204-4820
Phone
(509) 934-4070
NPI assigned
Aug 29, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X N361481193 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2268072 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95026895 CA
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X AP61478064 WA Primary

Addresses

Primary practice location

104 W 5TH Ave
Spokane, WA 99204-4820

Mailing address

6 Liberty SQ # 2463
Boston, MA 02109-5800
Phone (978) 342-3680

Other practice location 1

143 Westminster St Apt 2
Fitchburg, MA 01420-3755
Phone (978) 342-3680

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
I20240105003934 WA Practitioner - Nurse Practitioner 6800247669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spokane Behavioral Health LLCGroup PAC ID 2961757489, 24 clinicians

Practice addresses (Care Compare)

104 W 5TH Ave
Spokane, WA 99204-4820
Phone (623) 670-0840

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95026895CAMDPsychiatric/Mental Health Nurse Practitioner
RN2268072MAMDPsychiatric/Mental Health Nurse Practitioner
AP61478064WAMDPsychiatric/Mental Health Nurse Practitioner
N361481193WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spokane Behavioral Health LLC Single Specialty CurrentSince Nov 27, 2023 Accepting new patients

Locations

104 W 5th Ave
Spokane, WA 99204
Phone (509) 992-1888

Organizations & group practices 1

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": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1124803192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LIBERTY SQ # 2463",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021095800",
            "telephone_number": "978-342-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992044820",
            "telephone_number": "509-934-4070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "143 Westminster St Apt 2",
            "address_purpose": "LOCATION",
            "city": "Fitchburg",
            "state": "MA",
            "postal_code": "014203755",
            "country_code": "US",
            "telephone_number": "978-342-3680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MWANGI",
        "first_name": "BERNARD",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-29",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "N361481193",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2268072",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95026895",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61478064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.