Individual provider Active NPI

Victoria Anne Perkis, ARNP

  • Pediatric Nurse Practitioner
  • Ellensburg, WA
National Provider Identifier
1457494288
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP30003458 Issued in WA
Practice address
611 S Chestnut St
Suite E
Ellensburg, WA 98926-4815
Phone
(509) 962-5437
Fax
(509) 962-5438
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP30003458 WA Primary

Addresses

Primary practice location

611 S Chestnut St
Suite E
Ellensburg, WA 98926-4815

Mailing address

611 S Chestnut St
Suite E
Ellensburg, WA 98926-4815
Phone (509) 962-5437

Other identifiers 2

IdentifierTypeStateIssuer
RN00116364OtherWARN LICENSE
AP30003458OtherWAARNP LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP30003458WAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457494288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S CHESTNUT ST",
            "address_2": "SUITE E",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989264815",
            "telephone_number": "509-962-5437",
            "fax_number": "509-962-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S CHESTNUT ST",
            "address_2": "SUITE E",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989264815",
            "telephone_number": "509-962-5437",
            "fax_number": "509-962-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKIS",
        "first_name": "VICTORIA",
        "middle_name": "ANNE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP30003458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN00116364",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "AP30003458",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellensburg, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.