Charisao Srisuthipornsakul, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60435520 Issued in WA

Practice address

7201 W Grandridge Blvd
Kennewick, WA 99336-6709

Phone

(509) 221-6900

NPI assigned

Jan 26, 2011

Last updated

Aug 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

RCCH Trios Health LLCGroup PAC ID 5799035416, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trios Health Hospital, Kennewick, WA, CCN 500053

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charisao.srisuthipornsakul.1@18485.direct.athenahealth.com

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.

• RCCH Trios Health LLC

  • Internal Medicine Physician
  • Kennewick, WA
  • NPI 1831682806
  Medicare reassignment Care Compare group NPD
• Tri-Cities Digestive Health Center, PS

  • Endoscopy Clinic/Center
  • Kennewick, WA
  • NPI 1003987868
  Medicare reassignment NPD
• Mid-Columbia Endoscopy Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Kennewick, WA
  • NPI 1184926834
  NPD (past)
• Tri Cities Community Health

  • Federally Qualified Health Center (FQHC)
  • Pasco, WA
  • NPI 1659995504
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• RCCH Trios Health LLC

  • General Acute Care Hospital
  • Kennewick, WA
  • NPI 1578058137
  Care Compare affiliation

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1609172444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 CAMY ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993527868",
            "telephone_number": "608-772-6123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 W GRANDRIDGE BLVD",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366709",
            "telephone_number": "509-221-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRISUTHIPORNSAKUL",
        "first_name": "CHARISAO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5098-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209008323",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60435520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Spilles, RDH
• Nicholas Lawrence Spinetta
• Melodie Spradling
• Glenda Rae Springer, M.S.P.T
• Carie Squires
• Allison Stallcop
• Ruby Stallings
• Cara Linda Stanfield
• Marcia Denise Stangeland, M.ED.
• Gerald N Stanley, DO

• Family Nurse Practitioner in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.