Charmaine R Allen-Johnson, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP451A Issued in ID

Practice address

619 Diagonal St
Clarkston, WA 99403-2041

Phone

(509) 758-9003

Fax

(509) 758-9001

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2019 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Merrifield and Associates Inc

  • Family Medicine Physician
  • Richland, WA
  • NPI 1780851634
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1235259748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SOUTHPORT AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014523",
            "telephone_number": "208-743-3142",
            "fax_number": "208-743-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 DIAGONAL ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032041",
            "telephone_number": "509-758-9003",
            "fax_number": "509-758-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN-JOHNSON",
        "first_name": "CHARMAINE",
        "middle_name": "R",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP3005439",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP451A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1786607",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohamad Altayeb Al-Hafez, MD
• Jackie L Alas, MSW
• Albertsons LLC
• Mayra Albor-Martinez
• Noha Emhammed Algallai
• Elizabeth Marie Allen-Racicot, L.M.P.
• Alpowa Healthcare, Inc.
• Jennifer D Ambriz, MASTER ED
• Ashley Nicole Anderson
• Tyler Lee Anderson, PA-C

• Family Nurse Practitioner in Clarkston, WA
• Providers in Clarkston, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.