Individual provider Active NPI

Josephat Muthiga Mutahi

  • Family Nurse Practitioner
  • Federal Way, WA
National Provider Identifier
1801315585
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61171292 Issued in WA
Practice address
33520 21St Ave SW
Federal Way, WA 98023-2874
Phone
(253) 838-1611
NPI assigned
Sep 14, 2017
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5407 MN
Family Nurse Practitioner 363LF0000X AP61171292 WA Primary
Registered Nurse 163W00000X 1939222 MN
Registered Nurse 163W00000X AP61171294 WA

Addresses

Primary practice location

33520 21St Ave SW
Federal Way, WA 98023-2874

Mailing address

33520 21St Ave SW
Federal Way, WA 98023-2874
Phone (253) 838-1611

Other practice location 1

9201 E Mountain View Rd
Scottsdale, AZ 85258-5199
Phone (877) 564-3627

Other practice location 2

949 Chloe Ln
Eagan, MN 55123-2613
Phone (651) 747-7148

Other practice location 3

4241 Johnny Cake Ridge Rd
Eagan, MN 55122-2235
Phone (651) 747-7148

Other practice location 4

9201 E Mountain View Rd
Scottsdale, AZ 85258-5199
Phone (877) 564-3627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1939222MNMDRegistered Nurse
AP61171294WAMDRegistered Nurse
5407MNMDSpeech-Language Pathologist
AP61171292WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverwalk Adult Family Home LLC Registered Nurse Current Accepting new patients
Matrix Medical Plus CurrentSince Jun 1, 2023 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

121 Washington Ave N
Fl 4
Minneapolis, MN 55401
Phone (404) 992-2702

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1801315585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33520 21ST AVE SW",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232874",
            "telephone_number": "253-838-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33520 21ST AVE SW",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232874",
            "telephone_number": "253-838-1611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9201 E Mountain View Rd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852585199",
            "country_code": "US",
            "telephone_number": "877-564-3627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "949 Chloe Ln",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551232613",
            "country_code": "US",
            "telephone_number": "651-747-7148",
            "fax_number": "651-204-0300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4241 Johnny Cake Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551222235",
            "country_code": "US",
            "telephone_number": "651-747-7148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9201 E Mountain View Rd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852585199",
            "country_code": "US",
            "telephone_number": "877-564-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUTAHI",
        "first_name": "JOSEPHAT",
        "middle_name": "MUTHIGA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-14",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "5407",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61171292",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "1939222",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "AP61171294",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.