Active NPI
Diane H. Root-Racine, ARNP
- Family Nurse Practitioner
- Sequim, WA
National Provider Identifier
1881647832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP60004129
- Practice address
- 808 N 5TH Ave
Sequim, WA 98382-3045 - Phone
- (360) 683-5900
- Fax
- (360) 582-4800
- NPI assigned
- May 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP60004129 | WA | Primary |
Addresses
Primary practice location
808 N 5TH Ave
Sequim, WA 98382-3045
Mailing address
808 N 5TH Ave
Sequim, WA 98382-3045
Phone (360) 683-5900
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9615790 | Medicaid | WA | |
| RO9766 | Other | WA | REGENCE DIANE ROOT-RACINE |
| 101638 | Other | WA | L&I DIANE ROOT-RACINE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60004129 | WA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sequim Physician Clinic | 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.
-
- Primary Care Clinic/Center
- Sequim, WA
- NPI 1740238054
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288656000000",
"number": "1881647832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 N 5TH AVE",
"city": "SEQUIM",
"state": "WA",
"postal_code": "983823045",
"telephone_number": "360-683-5900",
"fax_number": "360-582-4800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 N 5TH AVE",
"city": "SEQUIM",
"state": "WA",
"postal_code": "983823045",
"telephone_number": "360-683-5900",
"fax_number": "360-582-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOT-RACINE",
"first_name": "DIANE",
"middle_name": "H.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-19",
"last_updated": "2010-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP60004129",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9615790",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE DIANE ROOT-RACINE",
"identifier": "RO9766",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I DIANE ROOT-RACINE",
"identifier": "101638",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sequim, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.