Michael K Frizelle, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

60101140 Issued in WA

Practice address

77 Wainwright Dr VA Medical Center
Jonathan M Wainwright Memorial
Walla Walla, WA 99362-9814

Phone

(503) 440-3578

NPI assigned

Jul 31, 2008

Last updated

Oct 21, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1699931493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8875 ELLSWORTH CT NE",
            "address_2": "503",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985163883",
            "telephone_number": "503-440-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WAINWRIGHT DR VA MEDICAL CENTER",
            "address_2": "JONATHAN M WAINWRIGHT MEMORIAL",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993629814",
            "telephone_number": "503-440-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIZELLE",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "2962202",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "60101140",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "737610",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200843205RN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MILITARY PRACTICE ONLY",
            "identifier": "2962202",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PRACTICE ONLY",
            "identifier": "737610",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VETERAN ADMIN",
            "identifier": "200843205RN",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VETERAN ADMIN",
            "identifier": "60101140",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Walla Walla, WA
• Providers in Walla Walla, 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 Oct 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.