Nabatanzi Agnes Bewayo, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60752475 Issued in WA

Practice address

402 S 333Rd St Ste 105
Federal Way, WA 98003-7099

Phone

(971) 251-5788

NPI assigned

Oct 25, 2006

Last updated

Dec 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rainier Integrated Primary Care PLLC

  • Primary Care Clinic/Center
  • Federal Way, WA
  • NPI 1417552944
  NPD Authorized official
• Grady Memorial Hospital Corporation

  dba Grady Health Systems

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1861576761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 58608",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980581608",
            "telephone_number": "404-558-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S 333RD ST STE 105",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980037099",
            "telephone_number": "971-251-5788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 Franklin Springs St",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Royston",
            "state": "GA",
            "postal_code": "306623908",
            "country_code": "US",
            "telephone_number": "706-245-5050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24920 104th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "WA",
            "postal_code": "980306443",
            "country_code": "US",
            "telephone_number": "253-395-2000",
            "fax_number": "253-395-1956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEWAYO",
        "first_name": "NABATANZI",
        "middle_name": "AGNES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "047964",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60752475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2080457",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorinda K Betcher, LMP
• Richard Alan Bethke, MD
• Bethsaida
• Shanna Lynn Bethune, NP
• Sheridan Beuck
• Masresha M Beyene
• Yelena Akselrod Beygelman, DDS
• Asha Bhaga, CERTIFIED COUNSELOR
• Alnoor Bhanji, DC
• Elenore P Bhatraju, MD

• Family Medicine Physician in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.