Nicholas Fawcett
Individual provider Active NPI Certified Registered Nurse Anesthetist · Tacoma, WA
NPI 1295023331 · NPPES record last updated Dec 3, 2020
Key facts
- NPI
- 1295023331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- AP60911360 (WA)
- Practice address
- 1717 S J St
Tacoma, WA 98405-4933 - Phone
- (844) 364-2778
- Fax
- (253) 426-6344
- NPI assigned
- Jul 11, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Franciscan Medical Group
Practice addresses (Care Compare)
1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341
Hospital & facility affiliations
- St Elizabeth Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190326000770 | WA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 3577826551 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60911360 | WA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franciscan Medical Group | Current |
Accepting new patients | |
| Franciscan Medical Group | Current |
Accepting new patients |
Locations
34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340
1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200
1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | CRNA-01527 | NM | |
| Counselor | 101Y00000X | |||
| Certified Registered Nurse Anesthetist | 367500000X | AP60911360 | WA | Yes |
Addresses
Primary practice location
1717 S J St
Tacoma, WA 98405-4933
Mailing address
1717 S J St
Tacoma, WA 98405-4933
Phone (844) 364-2778
Other practice location 1
525 W. 200 N.
Mona, UT 84648
Phone (435) 623-2825
Other practice location 2
455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 913-3361
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2120832 | Medicaid | WA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nfawcett434065@fhsce.catholichealth.net | Direct |
Other providers in Tacoma, WA
- Taylor Farris
- Eva Pearl Farrukh
- Said Farzad
- Beth Ellen Faulkner
- Whitney Faulkner
- Haley Nicole Fawns-Sim
- Patricia A Fawver
- Sarah Fay
- Fayetteville Dialysis
- Eduardo Roberto Faytong
All providers in Tacoma, WA · Certified Registered Nurse Anesthetist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.