Individual provider Active NPI

Nicole Armitage

  • Surgical Physician Assistant
  • Spokane Valley, WA
National Provider Identifier
1225641855
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA61240797 Issued in WA
Practice address
16528 E Desmet CT
Spokane Valley, WA 99216-3522
Phone
(509) 944-8920
NPI assigned
Aug 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Physician Assistant 363AS0400X PA61240797 WA Primary

Addresses

Primary practice location

16528 E Desmet CT
Spokane Valley, WA 99216-3522

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other identifiers 2

IdentifierTypeStateIssuer
1225641855OtherWA1225641855
1225641855MedicaidWA

Other names 1

  • Nicole Suzanne Armitage Professional name

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
I20220211001755 WA Practitioner - Physician Assistant 9133512262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 E Columbia Ave
Colville, WA 99114-3354
Phone (509) 684-3701

16528 E Desmet CT
Spokane, WA 99216-3522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61240797WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Washington Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1225641855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16528 E DESMET CT",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992163522",
            "telephone_number": "509-944-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMITAGE",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61240797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1225641855",
            "identifier": "1225641855",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225641855",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "ARMITAGE",
            "middle_name": "SUZANNE",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.