Individual provider Active NPI

Brook Amber Raphael, DNP-FNP, ARNP

  • Family Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1912240060
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61178764 Issued in WA
Practice address
1802 Yakima Ave Ste 304
Tacoma, WA 98405-5305
Phone
(253) 627-1244
Fax
(253) 627-6576
NPI assigned
Mar 27, 2013
Last updated
Nov 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61178764 WA Primary
Nurse Practitioner 363L00000X AP61178764 WA

Addresses

Primary practice location

1802 Yakima Ave Ste 304
Tacoma, WA 98405-5305

Mailing address

1802 Yakima Ave Ste 304
Tacoma, WA 98405-5305
Phone (253) 627-1244

Other identifiers 1

IdentifierTypeStateIssuer
2183468MedicaidWA

Other names 1

  • Brook Johanson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bjohanson126456@fhsce.catholichealth.net Direct Franciscan Medical Group

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
I20210810000132 WA Practitioner - Nurse Practitioner 8820492143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1802 Yakima Ave
Suite 304
Tacoma, WA 98405-5305
Phone (253) 627-1244

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP61178764WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Aug 2, 2021 Accepting new patients
Franciscan Medical Group CurrentSince Aug 2, 2021 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

11311 Bridgeport Way SW
Ste 304
Tacoma, WA 98499
Phone (253) 983-1377

1802 Yakima Ave
Ste 302
Tacoma, WA 98405
Phone (253) 426-4697

1802 Yakima Ave
Ste 304
Tacoma, WA 98405
Phone (253) 572-7101

1802 Yakima Ave
Ste 307
Tacoma, WA 98405
Phone (206) 627-1244

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1912240060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 304",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055305",
            "telephone_number": "253-627-1244",
            "fax_number": "253-627-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 304",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055305",
            "telephone_number": "253-627-1244",
            "fax_number": "253-627-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPHAEL",
        "first_name": "BROOK",
        "middle_name": "AMBER",
        "credential": "DNP-FNP, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61178764",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61178764",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2183468",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bjohanson126456@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1802 Yakima Ave Ste 304",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BROOK",
            "last_name": "JOHANSON",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.