At Family Practice Group PS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

AT FAMILY PRACTICE GROUP PS

Practice address

24604 104TH Ave SE Ste 201
Kent, WA 98030-5385

Phone

(253) 854-9799

NPI assigned

Apr 25, 2023

Organization subpart

No

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

Authorized official

Name

Amandeep MannNPI 1669914354

Title

Provider

Phone

(253) 394-6574

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

Practitioners 2

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

• Amandeep Kaur Mann, FNP-C

  • Family Nurse Practitioner
  • Puyallup, WA
  • NPI 1669914354
  Medicare reassignment NPD Authorized official
• Amandeep Debessay, ARNP

  • Family Nurse Practitioner
  • Seattle, WA
  • NPI 1699540211
  Medicare reassignment NPD

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1346938685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24604 104TH AVE SE STE 201",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24604 104TH AVE SE STE 201",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305385",
            "telephone_number": "253-854-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT FAMILY PRACTICE GROUP PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "AMANDEEP",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "253-394-6574"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley House
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• Aspire Serenity Home Health Care Inc
• Associated Behavioral Health Care Inc
• Association of University Physicians
• Vahid All Atabakhsh, D.D.S
• Athletic Potential Performance Physical Therapy LLC
• Taylor Attri
• Attune Nutrition, PLLC
• David Au, RPH.

• Family Medicine Physician in Kent, WA
• Providers in Kent, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.