Active NPI
Margaret A Gorham, ARNP
- Nurse Practitioner
- Renton, WA
National Provider Identifier
1144302134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP30005897
- Practice address
- 4011 Talbot Rd S
Suite 500
Renton, WA 98055-5773 - Phone
- (425) 251-5110
- Fax
- (425) 793-7380
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN00C92207 | WA | |
| Nurse Practitioner | 363L00000X | AP30005897 | WA | Primary |
Addresses
Primary practice location
4011 Talbot Rd S
Suite 500
Renton, WA 98055-5773
Mailing address
PO Box 59028
Renton, WA 98058-2028
Phone (425) 251-5110
Other practice location 1
1221 Madison St Ste 1220
Seattle, WA 98104-1356
Phone (206) 215-4250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9632811 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mgorham1041759@wm.providencedirect.org | Direct |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN00C92207 | WA | MD | Registered Nurse |
Interoperability endpoints
- mgorham1041759@wm.providencedirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1144302134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 59028",
"city": "RENTON",
"state": "WA",
"postal_code": "980582028",
"telephone_number": "425-251-5110",
"fax_number": "425-793-4707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4011 TALBOT RD S",
"address_2": "SUITE 500",
"city": "RENTON",
"state": "WA",
"postal_code": "980555773",
"telephone_number": "425-251-5110",
"fax_number": "425-793-7380"
}
],
"practiceLocations": [
{
"address_1": "1221 Madison St Ste 1220",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981041356",
"country_code": "US",
"telephone_number": "206-215-4250",
"fax_number": "206-215-4252",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GORHAM",
"first_name": "MARGARET",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN00C92207",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP30005897",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9632811",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mgorham1041759@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1221 Madison St Ste 1220",
"city": "Seattle",
"state": "WA",
"country_code": "US",
"postal_code": "981041356",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.