NPIMap

Individual provider Active NPI

Annette Fly

  • Family Nurse Practitioner
  • Oak Harbor, WA
National Provider Identifier
1134480056
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60375338 Issued in WA
Practice address
1300 NE Goldie St
Oak Harbor, WA 98277-4832
Phone
(360) 679-5590
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60375338 WA Primary

Addresses

Primary practice location

1300 NE Goldie St
Oak Harbor, WA 98277-4832

Mailing address

PO Box 3603
Seattle, WA 98124-3603
Phone (206) 371-6289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130909000382 WA Practitioner - Nurse Practitioner 5193968378 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Whidbey Island Public Hospital DistrictGroup PAC ID 1658280680, 100 clinicians
Freeland Primary Care PLLCGroup PAC ID 4183860935, 5 clinicians

Practice addresses (Care Compare)

5486 Harbor Ave
Freeland, WA 98249-3002
Phone (360) 678-0831

5577 Vanbarr PL
Freeland, WA 98249-9555
Phone (360) 331-3343

Hospital & facility affiliations

  • Signature Healthcare at Home Home health agency, Burlington, WA, CCN 507100
  • Eden Home Health Home health agency, Bellingham, WA, CCN 507105
  • Whidbeyhealth Medical Center Hospital, Coupeville, WA, CCN 501339
  • Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60375338WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Whidbey Island Public Hospital District CurrentSince Apr 13, 2026 Accepting new patients
Freeland Primary Care PLLC CurrentSince Aug 1, 2019 Accepting new patients
Providence Health & Services-Washington CurrentSince Oct 5, 2019 Accepting new patients
Providence Health & Services-Wa Current Accepting new patients
Providence Health & Services-Wa CurrentSince Oct 5, 2019 Accepting new patients
Whidbey Island Public Hospital District Past Accepting new patients

Locations

11245 State Route 525
Clinton, WA 98236
Phone (360) 341-5252

101 N Main St
Coupeville, WA 98239
Phone (360) 678-7656

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

5486 Harbor Ave
Freeland, WA 98249
Phone (360) 331-5060

5577 Vanbarr Pl
Freeland, WA 98249
Phone (360) 320-9491

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

275 SE Cabot Dr
Ste B101
Oak Harbor, WA 98277
Phone (360) 675-6648

1300 NE Goldie St
Oak Harbor, WA 98277
Phone (360) 240-4070

Interoperability endpoints

  • Direct secure messaging: annette.fly.1@18257.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1134480056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3603",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243603",
            "telephone_number": "206-371-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 NE GOLDIE ST",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982774832",
            "telephone_number": "360-679-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLY",
        "first_name": "ANNETTE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60375338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Harbor, WA

Sources for this page

Verify at the official NPI Registry.