Individual provider Active NPI

Melissa Rae Bettes, ARNP

  • Nurse Practitioner
  • Longview, WA
National Provider Identifier
1134464365
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP 60291195 Issued in WA
Practice address
1718 E Kessler Blvd
Longview, WA 98632-1842
Phone
(360) 747-5800
Fax
(360) 575-3846
NPI assigned
Nov 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP 60291195 WA Primary

Addresses

Primary practice location

1718 E Kessler Blvd
Longview, WA 98632-1842

Mailing address

1718 E Kessler Blvd
Longview, WA 98632-1842
Phone (360) 747-5800

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
I20180227002441 WA Order and Referring Only - Nurse Practitioner 7214182757

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP 60291195WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Washington Cardiology TR Past Accepting new patients

Organizations & group practices 1

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": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1134464365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 E KESSLER BLVD",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986321842",
            "telephone_number": "360-747-5800",
            "fax_number": "360-575-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 E KESSLER BLVD",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986321842",
            "telephone_number": "360-747-5800",
            "fax_number": "360-575-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTES",
        "first_name": "MELISSA",
        "middle_name": "RAE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP 60291195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.