Individual provider Active NPI

Pratima Shrestha

  • Family Nurse Practitioner
  • Centralia, WA
National Provider Identifier
1508402785
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61337045 Issued in WA
Practice address
1800 Cooks Hill Rd Ste F
Centralia, WA 98531-9162
Phone
(360) 669-0335
Fax
(360) 736-2967
NPI assigned
Nov 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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 AP61337045 WA Primary

Addresses

Primary practice location

1800 Cooks Hill Rd Ste F
Centralia, WA 98531-9162

Mailing address

2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone (360) 330-9595

Other identifiers 1

IdentifierTypeStateIssuer
2214622MedicaidWA

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
I20221025002174 WA Practitioner - Nurse Practitioner 7012383599 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61337045WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Community Health Services CurrentSince Sep 7, 2022 Accepting new patients
Lewis County Community Health Services Current Accepting new patients
Lewis County Community Health Services CurrentSince Sep 7, 2022 Accepting new patients

Locations

1800 Cooks Hill Rd
Ste F
Centralia, WA 98531
Phone (360) 330-8939

2690 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 330-9595

Interoperability endpoints

  • Direct secure messaging: pratima.shresthadnp.p1@direct.valleyviewhc.nextgenshare.com

Organizations & group practices 3

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": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1508402785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322412",
            "telephone_number": "360-330-9595",
            "fax_number": "369-330-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COOKS HILL RD STE F",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319162",
            "telephone_number": "360-669-0335",
            "fax_number": "360-736-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRESTHA",
        "first_name": "PRATIMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-21",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61337045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2214622",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

Verify at the official NPI Registry.