Individual provider Active NPI

Karis Niemi, RN, PNP

  • Pediatric Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1457747586
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP60886618 Issued in WA
Practice address
700 NE 87TH Ave
Vancouver, WA 98664-4896
Phone
(360) 882-2778
NPI assigned
Apr 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X AP60886618 WA Primary

Addresses

Primary practice location

700 NE 87TH Ave
Vancouver, WA 98664-4896

Mailing address

PO Box 4825
Portland, OR 97208-4825
Phone (360) 882-2778

Other practice location 1

2121 NE 139th St Ste 200
Vancouver, WA 98686-2316
Phone (360) 487-1777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220706002868 WA Practitioner - Nurse Practitioner 7618357856 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Jul 25, 2022 Accepting new patients
The Vancouver Clinic Inc PS Multi-Specialty CurrentSince Jul 25, 2022 Accepting new patients
The Vancouver Clinic Inc PS Multi-Specialty Current Accepting new patients
Legacy Salmon Creek Hospital Multi-Specialty Past Accepting new patients
Peacehealth Multi-Specialty Past Accepting new patients

Locations

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

Interoperability endpoints

  • Direct secure messaging: kkerbs19739@tvc-direct.org

Organizations & group practices 5

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": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1457747586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084825",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE 87TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986644896",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 NE 139th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986862316",
            "country_code": "US",
            "telephone_number": "360-487-1777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEMI",
        "first_name": "KARIS",
        "credential": "RN, PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP60886618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.