Active NPI
Nutter & Moore PLLC
- Customized Equipment (DME)
- Vancouver, WA
National Provider Identifier
1396329058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- Legal business name
- NUTTER & MOORE PLLC
- Practice address
- 601 SE 117TH Ave Ste 230
Vancouver, WA 98683-5297 - Phone
- (360) 921-3588
- NPI assigned
- May 10, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Nutter
- Title
- Owner
- Phone
- (360) 921-3588
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | Primary |
Addresses
Primary practice location
601 SE 117TH Ave Ste 230
Vancouver, WA 98683-5297
Mailing address
601 SE 117TH Ave Ste 230
Vancouver, WA 98683-5297
Phone (360) 921-3588
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210825000858 | WA | DME Supplier - Oral Surgery - Dentist | 5991100273 | Practice locations: Vancouver, WA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Vancouver, WA
- NPI 1518088715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620604800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1620604800000",
"number": "1396329058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 SE 117TH AVE STE 230",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986835297",
"telephone_number": "360-921-3588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 SE 117TH AVE STE 230",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986835297",
"telephone_number": "360-921-3588"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NUTTER & MOORE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-10",
"last_updated": "2021-05-10",
"certification_date": "2021-05-10",
"status": "A",
"authorized_official_last_name": "NUTTER",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "360-921-3588"
},
"taxonomies": [
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.