Individual provider Active NPI

Annabeth Guzman McGuire, FNP

  • Family Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1487401915
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61568910 Issued in WA
Practice address
3754 W Indian Trail Rd
Spokane, WA 99208-4736
Phone
(509) 866-4112
NPI assigned
May 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60854203 WA
Family Nurse Practitioner 363LF0000X AP61568910 WA Primary

Addresses

Primary practice location

3754 W Indian Trail Rd
Spokane, WA 99208-4736

Mailing address

3754 W Indian Trail Rd
Spokane, WA 99208-4736
Phone (509) 866-4112

Other names 1

  • Annabeth Guzman Former name

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
I20240726003126 WA Practitioner - Nurse Practitioner 1658817515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Excelsior Family Medicine LLCGroup PAC ID 2567875065, 6 clinicians

Practice addresses (Care Compare)

3754 W Indian Trail Rd
Spokane, WA 99208-4736
Phone (509) 467-1100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61568910WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Excelsior Family Medicine LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

3754 W Indian Trail Rd
Spokane, WA 99208
Phone (509) 328-7041

Organizations & group practices 1

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": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1487401915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3754 W INDIAN TRAIL RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992084736",
            "telephone_number": "509-866-4112",
            "fax_number": "509-973-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3754 W INDIAN TRAIL RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992084736",
            "telephone_number": "509-866-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUIRE",
        "first_name": "ANNABETH",
        "middle_name": "GUZMAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60854203",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61568910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNABETH",
            "last_name": "GUZMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.