Organization Active NPI

Be Well Enterprises LLC

Doing business as Walla Walla Wellness

  • Family Nurse Practitioner
  • Walla Walla, WA
National Provider Identifier
1891576724
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
BE WELL ENTERPRISES LLC
Doing business as
Walla Walla Wellness
Practice address
694 W Rose St
Walla Walla, WA 99362-2707
Phone
(509) 529-4676
Fax
(509) 525-1058
NPI assigned
Oct 6, 2023
Last updated
Mar 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BE WELL ENTERPRISES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Authorized official

Name
Trudy Sharp, ARNPNPI 1578839023
Title
Owner
Phone
(509) 529-4676

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Massage Therapist 225700000X NU

Addresses

Primary practice location

694 W Rose St
Walla Walla, WA 99362-2707

Mailing address

694 W Rose St
Walla Walla, WA 99362-2707
Phone (509) 529-4676

Other names 1

  • Walla Walla Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240822001661 WA Part B Supplier - Clinic/Group Practice 4688113632 Receives reassigned benefits from 1 practitioner
Practice locations: Walla Walla, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2162793Walla Walla Wellness694 S Rose St, Walla Walla, WA 99362Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Part of
Be Well Enterprises LLC

Locations

694 W Rose St
Walla Walla, WA 99362
Phone (509) 525-2759

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1696550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1891576724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 W ROSE ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622707",
            "telephone_number": "509-529-4676",
            "fax_number": "509-525-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 W ROSE ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622707",
            "telephone_number": "509-529-4676",
            "fax_number": "509-525-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BE WELL ENTERPRISES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BE WELL ENTERPRISES, LLC",
        "enumeration_date": "2023-10-06",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "SHARP",
        "authorized_official_first_name": "TRUDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-529-4676",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walla Walla Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walla Walla Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.