Individual provider Active NPI

Margaret E. Sackmann, ARNP/GNP

  • Gerontology Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1801814579
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP30001790 Issued in WA
Practice address
5115 Beverly Ave NE
Tacoma, WA 98422-1823
Phone
(253) 952-3130
Fax
(253) 927-2119
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP30001790 WA Primary

Addresses

Primary practice location

5115 Beverly Ave NE
Tacoma, WA 98422-1823

Mailing address

5115 Beverly Ave NE
Tacoma, WA 98422-1823
Phone (253) 797-6239

Other identifiers 2

IdentifierTypeStateIssuer
2005946MedicaidWA
AP30001790OtherWAWA LICENSE

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
AP30001790WAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Munoz Regimbal and Associates Physicians Professional LLC Past Accepting new patients

Organizations & group practices 1

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1801814579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 BEVERLY AVE NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984221823",
            "telephone_number": "253-797-6239",
            "fax_number": "253-927-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 BEVERLY AVE NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984221823",
            "telephone_number": "253-952-3130",
            "fax_number": "253-927-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKMANN",
        "first_name": "MARGARET",
        "middle_name": "E.",
        "credential": "ARNP/GNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP30001790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005946",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LICENSE",
            "identifier": "AP30001790",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.