Individual provider Active NPI

Nathan Todd Anderson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bellingham, WA
National Provider Identifier
1861183592
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61410607 Issued in WA
Practice address
1616 Cornwall Ave Ste 205
Bellingham, WA 98225-4642
Phone
(360) 676-6177
Fax
(360) 671-3574
NPI assigned
May 15, 2023
Last updated
May 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61410607 WA Primary

Addresses

Primary practice location

1616 Cornwall Ave Ste 205
Bellingham, WA 98225-4642

Mailing address

1744 Sapphire TRL
Bellingham, WA 98226-7838
Phone (720) 206-8522

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230727003323 WA Practitioner - Nurse Practitioner 1355702077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unity Care NorthwestGroup PAC ID 7911897699, 39 clinicians

Practice addresses (Care Compare)

1616 Cornwall Ave
Bellingham, WA 98225-4648
Phone (360) 676-6177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61410607WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Care Northwest CurrentSince Aug 1, 2023 Accepting new patients
Unity Care Northwest CurrentSince Aug 1, 2023 Accepting new patients
Unity Care Northwest Current Accepting new patients

Locations

1616 Cornwall Ave
Bellingham, WA 98225
Phone (360) 305-3275

1616 Cornwall Ave
Ste 205
Bellingham, WA 98225
Phone (360) 671-6177

220 Unity St
Bellingham, WA 98225
Phone (360) 788-2623

Interoperability endpoints

  • Direct secure messaging: nanderson748474@direct.ochin.org

Organizations & group practices 3

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": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1861183592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 SAPPHIRE TRL",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267838",
            "telephone_number": "720-206-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 CORNWALL AVE STE 205",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254642",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "NATHAN",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61410607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.