Active NPI
Mario Banuelos
- Community Health Worker
- Bellingham, WA
National Provider Identifier
1134812175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 3201 Northwest Ave Ste 6
Bellingham, WA 98225-1363 - Phone
- (360) 602-1733
- NPI assigned
- May 26, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Interpreter | 171R00000X | |||
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Eyewear Supplier | 332H00000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Home Delivered Meals | 332U00000X | |||
| Non-emergency Medical Transport (VAN) | 343900000X | |||
| Taxi | 344600000X | |||
| Day Training/Habilitation Specialist | 373H00000X | |||
| Home Health Aide | 374U00000X | |||
| Doula | 374J00000X | |||
| Community Health Worker | 172V00000X | Primary | ||
| Pastoral Counselor | 101YP1600X |
Addresses
Primary practice location
3201 Northwest Ave Ste 6
Bellingham, WA 98225-1363
Mailing address
3201 Northwest Ave Ste 6
Bellingham, WA 98225-1363
Phone (360) 602-1733
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685059200000",
"number": "1134812175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201 NORTHWEST AVE STE 6",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251363",
"telephone_number": "360-602-1733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 NORTHWEST AVE STE 6",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251363",
"telephone_number": "360-602-1733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANUELOS",
"first_name": "MARIO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-26",
"last_updated": "2023-05-26",
"certification_date": "2023-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "171R00000X",
"taxonomy_group": "",
"desc": "Interpreter",
"state": null,
"license": null,
"primary": false
},
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": false
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "332U00000X",
"taxonomy_group": "",
"desc": "Home Delivered Meals",
"state": null,
"license": null,
"primary": false
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
},
{
"code": "344600000X",
"taxonomy_group": "",
"desc": "Taxi",
"state": null,
"license": null,
"primary": false
},
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.