Active NPI
Nikolai Reitz
- Student in an Organized Health Care Education/Training Program
- Chehalis, WA
National Provider Identifier
1083466247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 931 S Market Blvd, Chehalis, Wa 98532
Chehalis, WA 98532 - Phone
- (360) 767-6300
- NPI assigned
- Apr 2, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
931 S Market Blvd, Chehalis, Wa 98532
Chehalis, WA 98532
Mailing address
1113 Blu Steele Way
Pineville, NC 28134-8638
Phone (907) 203-9062
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250806000036 | WA | Order and Referring Only - Family Practice | 1254849607 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1083466247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1113 BLU STEELE WAY",
"city": "PINEVILLE",
"state": "NC",
"postal_code": "281348638",
"telephone_number": "907-203-9062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "931 S MARKET BLVD, CHEHALIS, WA 98532",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "98532",
"telephone_number": "360-767-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REITZ",
"first_name": "NIKOLAI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-02",
"last_updated": "2024-04-02",
"certification_date": "2024-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chehalis, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.