Individual provider Active NPI

Misty Nason

  • Registered Dietitian
  • Puyallup, WA
National Provider Identifier
1407047095
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI00001322 Issued in WA
Practice address
201 15TH Ave SW
Puyallup, WA 98371-7495
Phone
(253) 376-7792
NPI assigned
Aug 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI00001322 WA Primary

Addresses

Primary practice location

201 15TH Ave SW
Puyallup, WA 98371-7495

Mailing address

13220 96TH Avenue CT E
Puyallup, WA 98373-5528
Phone (253) 376-7792

Other practice location 1

702 S Hill Park Dr
Ste 105
Puyallup, WA 98373-1426
Phone (253) 445-7523

Other identifiers 1

IdentifierTypeStateIssuer
DI00001322OtherWAWASHINGTON STATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190819003391 WA Practitioner - Registered Dietitian Or Nutrition Professional 1052649746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2910 S Meridian
Suite 206
Puyallup, WA 98373-1585
Phone (253) 376-7792

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI00001322WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Viva Nutrition Counseling LLC Dietitian, Registered CurrentSince May 17, 2019 Accepting new patients
Commonspirit Washington Past Accepting new patients

Locations

2910 S Meridian
Ste 206
Puyallup, WA 98373
Phone (253) 376-7792

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1407047095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13220 96TH AVENUE CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735528",
            "telephone_number": "253-376-7792",
            "fax_number": "253-322-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 15TH AVE SW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717495",
            "telephone_number": "253-376-7792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "702 S Hill Park Dr",
            "address_2": "Ste 105",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983731426",
            "country_code": "US",
            "telephone_number": "253-445-7523",
            "fax_number": "253-426-6014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASON",
        "first_name": "MISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00001322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE LICENSE NUMBER",
            "identifier": "DI00001322",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.