Active NPI
Beverly Ann Huddleston, ARNP
- Obstetrics & Gynecology Nurse Practitioner
- Centralia, WA
National Provider Identifier
1063521870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- AP30004059
- Practice address
- 1000 S Scheuber Rd
PMG SW Wa Centralia Women Center
Centralia, WA 98531-8877 - Phone
- (360) 330-8950
- Fax
- (360) 330-8955
- NPI assigned
- Aug 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | AP30004059 | WA | Primary |
Addresses
Primary practice location
1000 S Scheuber Rd
PMG SW Wa Centralia Women Center
Centralia, WA 98531-8877
Mailing address
PO Box 3360
Portland, OR 97208-3360
Phone (360) 486-6508
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9612268 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bhuddleston92794@wm.providencedirect.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- bhuddleston92794@wm.providencedirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621555200000",
"number": "1063521870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3360",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083360",
"telephone_number": "360-486-6508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 S SCHEUBER RD",
"address_2": "PMG SW WA CENTRALIA WOMEN CENTER",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985318877",
"telephone_number": "360-330-8950",
"fax_number": "360-330-8955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDDLESTON",
"first_name": "BEVERLY",
"middle_name": "ANN",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2021-05-21",
"certification_date": "2021-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "WA",
"license": "AP30004059",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9612268",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bhuddleston92794@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1000 S Scheuber Rd",
"address_2": "PMG SW WA Centralia Women Center",
"city": "Centralia",
"state": "WA",
"country_code": "US",
"postal_code": "985318877",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.