Danelle Nick, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD60912797 Issued in WA

Practice address

55 W Tietan St
Walla Walla, WA 99362-4498

Phone

(509) 525-3720

NPI assigned

Apr 19, 2010

Last updated

Jan 8, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: danelle.nick.1@28594.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/28594/brand/1/csg/1/fhir/r4

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.

• Privia Medical Group Washington, PLLC

  dba Walla Walla Clinic (Professional)

  • Clinic/Center
  • Walla Walla, WA
  • NPI 1780658419
  Medicare reassignment NPD
• Walla Walla Clinic, Inc.

  dba Walla Walla Clinic Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Walla Walla, WA
  • NPI 1760568273
  NPD
• Walla Walla Clinic, Inc.

  dba Walla Walla Clinic Milton-Freewater

  • Clinic/Center
  • Milton Freewater, OR
  • NPI 1063521862
  NPD

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1245556026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624498",
            "telephone_number": "509-525-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624498",
            "telephone_number": "509-525-3720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_2": "GME Office CP 21005",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-8131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICK",
        "first_name": "DANELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60912797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Renee Freismidl Newcomb, PA-C
• Elliott Newman
• Douglas E Newton, MD
• Benjamin Nichols
• Jazmin Nichols
• Nielson Eye Care
• Amy L Nielson, LSWAIC
• Bradley Kyle Nielson, OD
• Trudee Kaye Nims, R.D.
• Fnu Nisina

• Pediatrics Physician in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.