Individual provider Active NPI

Vivian H Sharp, PA-C

  • Physician Assistant
  • Puyallup, WA
National Provider Identifier
1568794543
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60118140 Issued in WA
Practice address
1703 S Meridian Ste 305
Puyallup, WA 98371-7590
Phone
(253) 841-3933
Fax
(253) 848-7970
NPI assigned
Feb 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60118140 WA Primary

Addresses

Primary practice location

1703 S Meridian Ste 305
Puyallup, WA 98371-7590

Mailing address

1703 S Meridian Ste 305
Puyallup, WA 98371-7590

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
I20100407000198 WA Practitioner - Physician Assistant 9436285061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians

Practice addresses (Care Compare)

1703 S Meridian
Puyallup, WA 98371-7590
Phone (253) 841-3933

17700 SE 272ND St
Suite 420
Kent, WA 98042-4951
Phone (253) 639-9660

1901 S Union Ave
Tacoma, WA 98405-1702
Phone (253) 459-6633

33915 1St Way S
Federal Way, WA 98003-6396
Phone (253) 838-9839

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60118140WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Gastroenterology PLLC CurrentSince Jan 7, 2019 Accepting new patients
Washington Gastroenterology PLLC Physician Assistant Past Accepting new patients

Locations

2727 Hollycroft St
Ste 380
Gig Harbor, WA 98335
Phone (253) 858-0112

17700 SE 272nd St
Ste 420
Kent, WA 98042
Phone (253) 639-9660

11216 Sunrise Blvd E
Ste 3-207
Puyallup, WA 98374

1703 S Meridian
Ste 305
Puyallup, WA 98371
Phone (253) 841-3933

2202 S Cedar St
Ste 330
Tacoma, WA 98405
Phone (253) 503-2547

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.

Hospital & facility affiliations 2

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": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1568794543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN STE 305",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN STE 305",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-841-3933",
            "fax_number": "253-848-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "VIVIAN",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-02",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60118140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.