Individual provider Active NPI

Sandra V. Werner, MD

  • Family Medicine Physician
  • Spanaway, WA
National Provider Identifier
1639279656
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60485823 Issued in WA
Practice address
134 188TH St S
Spanaway, WA 98387-4618
Phone
(253) 847-2304
Fax
(253) 847-8857
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD25285 OR
Family Medicine Physician 207Q00000X MD60485823 WA Primary

Addresses

Primary practice location

134 188TH St S
Spanaway, WA 98387-4618

Mailing address

1019 Pacific Ave
Ste. 300
Tacoma, WA 98402-4443
Phone (253) 597-4550

Other identifiers 1

IdentifierTypeStateIssuer
022664MedicaidOR

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150829000195 WA Practitioner - Obstetrics/GynecologyPractitioner - Family Practice 0749260883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Family Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health CareGroup PAC ID 1850201559, 72 clinicians

Practice addresses (Care Compare)

134 188TH St S
Spanaway, WA 98387-4618
Phone (253) 847-2304

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60485823WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care CurrentSince Jun 30, 2015 Accepting new patients
Community Health Care CurrentSince Jun 30, 2015 Accepting new patients
Community Health Care Past Accepting new patients
Community Health Care Past Accepting new patients

Locations

134 188th St S
Spanaway, WA 98387
Phone (253) 847-2304

11225 Pacific Ave S
Tacoma, WA 98444
Phone (253) 536-2020

1148 Broadway
Ste 100
Tacoma, WA 98402
Phone (253) 441-4742

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEDCAA
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: sandra.wernermd.p1@direct.chc-tacoma.nextgenshare.com

Organizations & group practices 4

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 3

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1639279656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 PACIFIC AVE",
            "address_2": "STE. 300",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024443",
            "telephone_number": "253-597-4550",
            "fax_number": "253-597-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 188TH ST S",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983874618",
            "telephone_number": "253-847-2304",
            "fax_number": "253-847-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "SANDRA",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD25285",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60485823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022664",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanaway, WA

Sources for this page

Verify at the official NPI Registry.