Individual provider Active NPI

Dianna L Kaiser, ARNP

  • Primary Care Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1962516377
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP30007397 Issued in WA
Practice address
4324 Martin Way E Ste B
Olympia, WA 98516-5367
Phone
(360) 480-3427
NPI assigned
Aug 19, 2006
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP30007397 WA Primary

Addresses

Primary practice location

4324 Martin Way E Ste B
Olympia, WA 98516-5367

Mailing address

1629 Bellerive Way SE
Olympia, WA 98501-8606
Phone (360) 485-7241

Other identifiers 1

IdentifierTypeStateIssuer
2049663MedicaidWA

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
I20151114000036 WA Practitioner - Nurse Practitioner 4880904234 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor County Public Hospital District No 1 CurrentSince Apr 24, 2023 Accepting new patients
Grays Harbor County Public Hospital District No. 1 CurrentSince Apr 24, 2023 Accepting new patients
Public Hospital District No 1 of Mason County CurrentSince Oct 25, 2015 Accepting new patients
Public Hospital District No 1 of Mason County Wa CurrentSince Oct 25, 2015 Accepting new patients
Grays Harbor County Public Hospital District No 1 Current Accepting new patients
Public Hospital District No 1 of Mason County Current Accepting new patients

Locations

600 E Main St
Elma, WA 98541
Phone (360) 346-2222

610 E Main St
Elma, WA 98541
Phone (360) 346-2222

237 Professional Way
Shelton, WA 98584
Phone (360) 426-2500

901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1962516377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 BELLERIVE WAY SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985018606",
            "telephone_number": "360-485-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4324 MARTIN WAY E STE B",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985165367",
            "telephone_number": "360-480-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "DIANNA",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP30007397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2049663",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.