Deborah L Fertakis, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30006059 Issued in WA

Practice address

212 E Central Ave
Suite 315
Spokane, WA 99208-6291

Phone

(509) 465-3919

Fax

(509) 468-0705

NPI assigned

Feb 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 2

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Luke's Rehabilitation Medical Center Inpatient rehabilitation facility, Spokane, WA, CCN 503025

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dfertakis219662@wm.providencedirect.org

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.

• Providence Health & Services Washington

  dba Providence Medical Group

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Washington

  dba PMG PHC Providence Express Care

  • General Practice Physician
  • Spokane, WA
  • NPI 1306391446
  NPD

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

• Providence Health & Services- Washington

  dba Providence St Lukes Rehabilitation Medical Center

  • Rehabilitation Hospital
  • Spokane, WA
  • NPI 1497752091

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1710015110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E CENTRAL AVE",
            "address_2": "SUITE 315",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086291",
            "telephone_number": "509-465-3919",
            "fax_number": "509-468-0705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9631 N Nevada St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992181193",
            "country_code": "US",
            "telephone_number": "509-465-3919",
            "fax_number": "509-468-0705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERTAKIS",
        "first_name": "DEBORAH",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30006059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9646332",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1154414761",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dfertakis219662@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9631 N Nevada St Ste 300",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992181193",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dfertakis219662@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "212 E Central Ave",
            "address_2": "Suite 315",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992086291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Benjamin Trevor Ferrel, DO
• Donise S Ferrel, CRNA
• Michael C Ferries, MD
• Lance J Ferrin, MD
• Susanne Marie Ferro, PT
• Meseret Feser
• Grace K Fetters, RN
• Sean William Fetters
• Danielle Fetzer
• Keith Feusier

• Family Nurse Practitioner in Spokane, WA
• Providers in Spokane, 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 May 18, 2021; 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.