Individual provider Active NPI

Betsy Anne Johnson, ARNP

  • Family Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1679762165
Registry record updated Mar 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30004909 Issued in WA
Practice address
1742 Market St
Ste. 102
Tacoma, WA 98402-3223
Phone
(253) 692-5811
Fax
(253) 692-4768
NPI assigned
Oct 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2011

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 AP30004909 WA Primary

Addresses

Primary practice location

1742 Market St
Ste. 102
Tacoma, WA 98402-3223

Mailing address

1742 Market St
Ste. 102
Tacoma, WA 98402-3223
Phone (253) 692-5811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180601001190 TX Practitioner - Nurse Practitioner 7113996687 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wahkiakum County Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299283200000",
    "number": "1679762165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1742 MARKET ST",
            "address_2": "STE. 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023223",
            "telephone_number": "253-692-5811",
            "fax_number": "253-692-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1742 MARKET ST",
            "address_2": "STE. 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023223",
            "telephone_number": "253-692-5811",
            "fax_number": "253-692-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BETSY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-19",
        "last_updated": "2011-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30004909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.