Individual provider Active NPI

Colby Christopherson, ARNP

  • Gerontology Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1932686797
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP60892185 Issued in WA
Practice address
1802 Yakima Ave Ste 102
Tacoma, WA 98405-5303
Phone
(253) 272-7777
Fax
(253) 426-6344
NPI assigned
Jul 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP60892185 WA
Gerontology Nurse Practitioner 363LG0600X AP60892185 WA Primary

Addresses

Primary practice location

1802 Yakima Ave Ste 102
Tacoma, WA 98405-5303

Mailing address

1802 Yakima Ave Ste 102
Tacoma, WA 98405-5303
Phone (253) 272-7777

Other identifiers 1

IdentifierTypeStateIssuer
2108282MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cchristopherson11007@fhsce.catholichealth.net Direct

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
I20181112001872 WA Practitioner - Nurse Practitioner 7315291283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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)

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60892185WAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Sep 5, 2018 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

1802 Yakima Ave
Ste 102
Tacoma, WA 98405
Phone (253) 272-7777

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

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1932686797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055303",
            "telephone_number": "253-272-7777",
            "fax_number": "253-426-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055303",
            "telephone_number": "253-272-7777",
            "fax_number": "253-426-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHERSON",
        "first_name": "COLBY",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-25",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP60892185",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP60892185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2108282",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cchristopherson11007@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1802 Yakima Ave Ste 102",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.