Individual provider Active NPI

Rhonda Renee Eisenberg

  • Family Nurse Practitioner
  • Lynden, WA
National Provider Identifier
1699423285
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61276874 Issued in WA
Practice address
1518 D St
Lynden, WA 98264-2027
Phone
(360) 224-8988
NPI assigned
Mar 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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 AP61276874 WA Primary

Addresses

Primary practice location

1518 D St
Lynden, WA 98264-2027

Mailing address

1518 D St
Lynden, WA 98264-2027
Phone (360) 224-8988

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
I20231227002713 WA Practitioner - Nurse Practitioner 2961852355 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61276874WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healing in the Balance Current Accepting new patients
Cascade Clinic Walk in and Primary Care LLC CurrentSince Oct 18, 2023 Accepting new patients
Premier Diabetes Care, PLLC PastSince Oct 18, 2023 Accepting new patients

Locations

1420 Roosevelt Ave
Ste 4
Mount Vernon, WA 98273
Phone (360) 899-4086

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.

NPI Registry JSON

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1699423285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 D ST",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982642027",
            "telephone_number": "360-224-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 D ST",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982642027",
            "telephone_number": "360-224-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "RHONDA",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61276874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynden, WA

Sources for this page

Verify at the official NPI Registry.