Active NPI
Nancy P Nelson, ARNP
- Pediatric Nurse Practitioner
- Olympia, WA
National Provider Identifier
1164441820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- AP30005123
- Practice address
- 615 Lilly Rd NE
Suite 140
Olympia, WA 98506-5117 - Phone
- (360) 459-5009
- Fax
- (360) 459-8785
- NPI assigned
- Jul 19, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | AP30005123 | WA | Primary |
Addresses
Primary practice location
615 Lilly Rd NE
Suite 140
Olympia, WA 98506-5117
Mailing address
615 Lilly Rd NE
Suite 140
Olympia, WA 98506-5117
Phone (360) 459-5009
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9627829 | Medicaid | WA | |
| 4301017 | Medicaid | MT | |
| NP345WA | Medicaid | AK |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP30005123 | WA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seattle Children's Hospital | 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.
-
- Home Infusion Agency
- Bothell, WA
- NPI 1245383348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164441820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 LILLY RD NE",
"address_2": "SUITE 140",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065117",
"telephone_number": "360-459-5009",
"fax_number": "360-459-8785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 LILLY RD NE",
"address_2": "SUITE 140",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065117",
"telephone_number": "360-459-5009",
"fax_number": "360-459-8785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "NANCY",
"middle_name": "P",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "WA",
"license": "AP30005123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9627829",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4301017",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP345WA",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.