Individual provider Active NPI

Tayler Hentges, DNP, FNP-C

  • Family Nurse Practitioner
  • Everett, WA
National Provider Identifier
1578245049
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61461709 Issued in WA
Practice address
4201 Rucker Ave
Everett, WA 98203-2215
Phone
(425) 382-4000
NPI assigned
Aug 3, 2023
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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 AP61461709 WA Primary

Addresses

Primary practice location

4201 Rucker Ave
Everett, WA 98203-2215

Mailing address

4201 Rucker Ave
Everett, WA 98203-2215

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
I20231127002799 WA Practitioner - Nurse Practitioner 7719335090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4201 Rucker Ave
Everett, WA 98203-2237
Phone (425) 382-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61461709WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Snohomish County CurrentSince Oct 16, 2023 Accepting new patients
Community Health Center of Snohomish County CurrentSince Oct 16, 2023 Accepting new patients

Locations

326 S Stillaguamish Ave
Arlington, WA 98223
Phone (360) 435-2144

23320 Highway 99
Edmonds, WA 98026
Phone (425) 640-5500

1019 112th St SW
Everett, WA 98204
Phone (425) 551-6001

1424 Broadway
Everett, WA 98201
Phone (425) 551-1000

4201 Rucker Ave
Everett, WA 98203
Phone (425) 382-4000

8609 Evergreen Way
Everett, WA 98208
Phone (425) 551-6200

930 N Broadway
Everett, WA 98201
Phone (425) 317-0300

4111 194th St SW
Lynnwood, WA 98036
Phone (425) 835-5200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1578245049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032215",
            "telephone_number": "425-382-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTGES",
        "first_name": "TAYLER",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61461709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.