Active NPI
Cheryl J Waitkevich, ARNP
- Family Nurse Practitioner
- Olympia, WA
National Provider Identifier
1386730133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP30006973
- Practice address
- 413 Lilly Rd NE
Olympia, WA 98506-5133 - Phone
- (360) 486-6402
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP30006973 | WA | Primary |
Addresses
Primary practice location
413 Lilly Rd NE
Olympia, WA 98506-5133
Mailing address
PO Box 3380
Portland, OR 97208-3380
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cwaitkevich99234@wm.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP30006973 | WA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619568000000",
"number": "1386730133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3380",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 LILLY RD NE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065133",
"telephone_number": "360-486-6402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITKEVICH",
"first_name": "CHERYL",
"middle_name": "J",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2021-04-28",
"certification_date": "2021-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP30006973",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cwaitkevich99234@wm.providencedirect.org",
"affiliation": "N",
"address_1": "413 Lilly Rd NE",
"city": "Olympia",
"state": "WA",
"country_code": "US",
"postal_code": "985065133",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.