NPIMap

Organization Active NPI

Julie a Dybbro Arnp LLC

Doing business as Complete Women's Health Care

  • Adult Health Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1548466253
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP30001995 Issued in WA
Legal business name
JULIE A DYBBRO ARNP LLC
Doing business as
Complete Women's Health Care
Practice address
200 Lilly Rd NE
Ste B2
Olympia, WA 98506-5427
Phone
(360) 754-9409
Fax
(360) 438-6760
NPI assigned
Jun 21, 2007
Last updated
Mar 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Authorized official

Name
Amy Kunkel
Title
Manager
Phone
(360) 754-9409

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP30001995 WA Primary
Family Nurse Practitioner 363LF0000X AP30004521 WA

Addresses

Primary practice location

200 Lilly Rd NE
Ste B2
Olympia, WA 98506-5427

Mailing address

200 Lilly Rd NE
Ste B2
Olympia, WA 98506-5427
Phone (360) 754-9409

Other identifiers 3

IdentifierTypeStateIssuer
9617192MedicaidWA
9624750MedicaidWA
DH2034OtherWARRM

Other names 1

  • Complete Women's Health Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051130000176 WA Part B Supplier - Clinic/Group Practice 9830119288 Receives reassigned benefits from 4 practitioners
Practice locations: Olympia, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D1041361Julie a Dybbro Arnp LLC200 Lilly Rd NE Suite B, Olympia, WA 98506Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory

Locations

200 Lilly Rd NE
Ste B2
Olympia, WA 98506
Phone (360) 754-9409

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1548466253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LILLY RD NE",
            "address_2": "STE B2",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065427",
            "telephone_number": "360-754-9409",
            "fax_number": "360-438-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LILLY RD NE",
            "address_2": "STE B2",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065427",
            "telephone_number": "360-754-9409",
            "fax_number": "360-438-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE A DYBBRO ARNP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "KUNKEL",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-754-9409"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP30001995",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30004521",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9617192",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9624750",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "DH2034",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Women's Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.