Individual provider Active NPI

Nancy Wairimu Minjire, ARNP

  • Family Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1457901555
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61004465 Issued in WA
Practice address
9537 Gravelly Lake Dr SW
Tacoma, WA 98499-1513
Phone
(253) 984-2000
Fax
(253) 383-0161
NPI assigned
Sep 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61004465 WA Primary

Addresses

Primary practice location

9537 Gravelly Lake Dr SW
Tacoma, WA 98499-1513

Mailing address

9537 Gravelly Lake Dr SW
Tacoma, WA 98499-1513
Phone (253) 984-2000

Other identifiers 1

IdentifierTypeStateIssuer
2145832MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nminjire40525@fhsce.catholichealth.net Direct

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
I20200310000203 WA Practitioner - Nurse Practitioner 5294163093 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mso Washington IncGroup PAC ID 1850292681, 14 clinicians

Practice addresses (Care Compare)

33400 8TH Ave S
Suite 232
Federal Way, WA 98003-6382
Phone (253) 584-3577

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61004465WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Medical Center Physicians LLC CurrentSince Mar 8, 2024 Accepting new patients
Primary Care at Home PLLC Family Current Accepting new patients
Mso Washington, Inc. CurrentSince Aug 8, 2024 Accepting new patients
Capital Medical Center Physicians LLC CurrentSince Mar 8, 2024 Accepting new patients

Locations

33400 8th Ave S
Ste 232
Federal Way, WA 98003

1420 Carpenter Rd SE
Lacey, WA 98503
Phone (360) 455-9159

3920 Capital Mall Dr SW
Ste 200
Olympia, WA 98502
Phone (360) 459-7282

4903 108th St SW
Tacoma, WA 98499
Phone (253) 584-3577

4901 108th St SW
Tacoma, WA 98499
Phone (253) 584-3577

Interoperability endpoints

  • Direct secure messaging: nminjire40525@fhsce.catholichealth.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1457901555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9537 GRAVELLY LAKE DR SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984991513",
            "telephone_number": "253-984-2000",
            "fax_number": "253-383-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9537 GRAVELLY LAKE DR SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984991513",
            "telephone_number": "253-984-2000",
            "fax_number": "253-383-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINJIRE",
        "first_name": "NANCY",
        "middle_name": "WAIRIMU",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61004465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2145832",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nminjire40525@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9537 Gravelly Lake Dr SW",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984991513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.