NPIMap

Organization Active NPI

Nurses Diversified Systems, Inc

  • Psychiatry Physician
  • Seattle, WA
National Provider Identifier
1831710722
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NURSES DIVERSIFIED SYSTEMS, INC
Practice address
219 1St Ave S Ste 310
Seattle, WA 98104-2551
Phone
(907) 374-0852
Fax
(907) 374-0854
NPI assigned
May 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
Teresa Ann Brown Lyons, ANPNPI 1043524218
Title
Director
Phone
(907) 374-0852

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

219 1St Ave S Ste 310
Seattle, WA 98104-2551

Mailing address

815 2ND Ave Ste 122
Fairbanks, AK 99701-4469
Phone (907) 374-0852

Other practice location 1

1511 3rd Ave Ste 903
Seattle, WA 98101-1626
Phone (907) 374-0852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200605000357 WA Part B Supplier - Clinic/Group Practice 7517127996 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Seattle, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

815 2nd Ave
Ste 122
Fairbanks, AK 99701
Phone (907) 328-9664

1511 3rd Ave
Ste 903
Seattle, WA 98101
Phone (206) 987-4559

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1831710722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 2ND AVE STE 122",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014469",
            "telephone_number": "907-374-0852",
            "fax_number": "907-374-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 1ST AVE S STE 310",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042551",
            "telephone_number": "907-374-0852",
            "fax_number": "907-374-0854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1511 3rd Ave Ste 903",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981011626",
            "country_code": "US",
            "telephone_number": "907-374-0852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NURSES DIVERSIFIED SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-01",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "ANN BROWN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "907-374-0852",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.