Active NPI
Risa Denenberg, ARNP
- Family Nurse Practitioner
- Lakewood, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP60030791
- Practice address
- 4905 108TH St SW
Lakewood, WA 98499-3724 - Phone
- (253) 581-3075
- Fax
- (253) 581-3178
- NPI assigned
- Dec 5, 2006
- Last updated
- Nov 23, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP60030791 | WA | Primary |
| Family Nurse Practitioner | 363LF0000X | SPOO8438 | PA | |
| Registered Nurse | 163W00000X | RN60029600 | WA |
Addresses
Primary practice location
4905 108TH St SW
Lakewood, WA 98499-3724
Mailing address
PO Box 98886
Lakewood, WA 98496-8886
Phone (253) 581-3075
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306904990 | Medicaid | WA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
526 S 9TH Ave
Sequim, WA 98382-3626
Phone (360) 683-5900
808 N 5TH Ave
Sequim, WA 98382-3045
Phone (360) 683-5900
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN60029600 | WA | MD | Registered Nurse |
| SPOO8438 | PA | MD | Family Nurse Practitioner |
| AP60030791 | WA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jamestown S'Klallam Tribe | Current | Accepting new patients | |
| Jamestown S'Klallam Tribe | Current | Accepting new patients | |
| Commonspirit Washington | Past | Accepting new patients |
Locations
526 S 9th Ave
Sequim, WA 98382
Phone (360) 681-7755
808 N 5th Ave
Sequim, WA 98382
Phone (360) 582-4840
Interoperability endpoints
- rdenenberg283237@wm.providencedirect.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Jamestown Family Health Clinic
- Federally Qualified Health Center (FQHC)
- Sequim, WA
- NPI 1134181555
-
dba Jamestown Family Health
- Family Medicine Physician
- Sequim, WA
- NPI 1528809761
-
dba Franciscan Pharmacy Tacoma
- Community/Retail Pharmacy
- Tacoma, WA
- NPI 1346588548
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Olympic Medical Center
- General Acute Care Hospital
- Port Angeles, WA
- NPI 1306845557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1306904990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 98886",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984968886",
"telephone_number": "253-581-3075",
"fax_number": "253-581-3178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4905 108TH ST SW",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984993724",
"telephone_number": "253-581-3075",
"fax_number": "253-581-3178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENENBERG",
"first_name": "RISA",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-05",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP60030791",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SPOO8438",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60029600",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306904990",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.