NPIMap

Individual provider Active NPI

Charissa E CHI, ARNP

  • Family Nurse Practitioner
  • Burien, WA
National Provider Identifier
1336653005
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60796423 Issued in WA
Practice address
16045 1St Ave S FL 1
Burien, WA 98148-1401
Phone
(206) 965-4100
Fax
(206) 965-4119
NPI assigned
Nov 16, 2017
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60796423 WA Primary

Addresses

Primary practice location

16045 1St Ave S FL 1
Burien, WA 98148-1401

Mailing address

16045 1St Ave S FL 1
Burien, WA 98148-1401
Phone (206) 965-4100

Other practice location 1

4310 Bridgeport Way W
University Place, WA 98466-4337
Phone (253) 301-5044

Other identifiers 1

IdentifierTypeStateIssuer
2096257MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180320001151 WA Practitioner - Nurse Practitioner 3779845300 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

16045 1St Ave S
FL 1
Burien, WA 98148-1401
Phone (206) 965-4124

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60796423WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Multicare Health System CurrentSince Oct 26, 2020 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Oct 26, 2020 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

2930 S Meridian
Ste 200
Puyallup, WA 98373
Phone (253) 445-7600

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

4215 49th Ave NE
Tacoma, WA 98422
Phone (253) 459-7699

521 S K St
Tacoma, WA 98405
Phone (253) 403-2900

4310 Bridgeport Way W
University Place, WA 98466
Phone (253) 459-7140

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1336653005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16045 1ST AVE S FL 1",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981481401",
            "telephone_number": "206-965-4100",
            "fax_number": "206-965-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16045 1ST AVE S FL 1",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981481401",
            "telephone_number": "206-965-4100",
            "fax_number": "206-965-4119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4310 Bridgeport Way W",
            "address_purpose": "LOCATION",
            "city": "University Place",
            "state": "WA",
            "postal_code": "984664337",
            "country_code": "US",
            "telephone_number": "253-301-5044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHI",
        "first_name": "CHARISSA",
        "middle_name": "E",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60796423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2096257",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.