Island Facial Aesthetics P.S.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

ISLAND FACIAL AESTHETICS P.S.

Practice address

30 NW Birch St
Coupeville, WA 98239-3103

Phone

(360) 678-1515

Fax

(360) 678-5037

NPI assigned

Feb 10, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Kristy Anderson, ARNPNPI 1104284033

Title

Owner

Phone

(360) 969-0805

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristy J Anderson, ARNP

  • Family Nurse Practitioner
  • Coupeville, WA
  • NPI 1104284033
  Medicare reassignment NPD Authorized official
• Shannon D Tumblin, ARNP

  • Family Nurse Practitioner
  • Coupeville, WA
  • NPI 1376166884
  Medicare reassignment NPD

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1164054961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NW BIRCH ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393103",
            "telephone_number": "360-678-1515",
            "fax_number": "360-678-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NW BIRCH ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393103",
            "telephone_number": "360-678-1515",
            "fax_number": "360-678-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND FACIAL AESTHETICS P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-969-0805",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surin Hohlachoff, MA 61422890
• Maryann Holden
• Benjamin T Hu, MD
• Island County Dermatology PLLC
• Island County Ultrasound
• Island Prosthetics & Orthotics, Inc.
• J Chalice Bailey LMFT CCTP PLLC
• Ellen Augustine Jacus, PA-C
• Rida Jamal, M.D.
• Janet E Colli PHD PLLC

• Nurse Practitioner in Coupeville, WA
• Providers in Coupeville, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.