Individual provider Active NPI

Rachel Vaivoda, CPNP-PC

  • Pediatric Nurse Practitioner
  • Lone Tree, CO
National Provider Identifier
1992250583
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN.0992520-NP Issued in CO
Practice address
10099 Ridgegate Pkwy Ste 290
Lone Tree, CO 80124-5534
Phone
(303) 803-1005
Fax
(303) 798-3248
NPI assigned
Aug 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APN.0992520-NP CO Primary

Addresses

Primary practice location

10099 Ridgegate Pkwy Ste 290
Lone Tree, CO 80124-5534

Mailing address

1805 Shea Center Dr Ste 301
Highlands Ranch, CO 80129-2251
Phone (303) 803-1005

Other practice location 1

7720 S Broadway Ste 540
Littleton, CO 80122-2635
Phone (303) 803-1005

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
I20211027001399 WA Practitioner - Nurse Practitioner 4880977339 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0992520-NPCOMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Children'S Hospital CurrentSince Sep 22, 2021 Accepting new patients
Seattle Childrens Hospital CurrentSince Sep 22, 2021 Accepting new patients
Seattle Children'S Hospital Current Accepting new patients
Seattle Children'S Hospital Past Accepting new patients
Onpoint Medical Group, LLC PastSince Sep 22, 2017 Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Interoperability endpoints

  • Direct secure messaging: rvaivoda152416@direct.seattlechildrens.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1992250583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 SHEA CENTER DR STE 301",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292251",
            "telephone_number": "303-803-1005",
            "fax_number": "303-798-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10099 RIDGEGATE PKWY STE 290",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245534",
            "telephone_number": "303-803-1005",
            "fax_number": "303-798-3248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7720 S Broadway Ste 540",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801222635",
            "country_code": "US",
            "telephone_number": "303-803-1005",
            "fax_number": "303-798-3248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAIVODA",
        "first_name": "RACHEL",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "APN.0992520-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

Verify at the official NPI Registry.