Individual provider Active NPI

Elizabeth H Siegel, ARNP

  • Family Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1295887461
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30001895 Issued in WA
Practice address
4816 She Nah Num Dr SE
Olympia, WA 98513-9105
Phone
(360) 459-5312
Fax
(360) 456-1557
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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 AP30001895 WA Primary

Addresses

Primary practice location

4816 She Nah Num Dr SE
Olympia, WA 98513-9105

Mailing address

4816 She Nah Num Dr SE
Olympia, WA 98513-9105
Phone (360) 459-5312

Other identifiers 1

IdentifierTypeStateIssuer
9604893MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100225000106 TX Practitioner - Nurse Practitioner 5395796130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nisqually Indian TribeGroup PAC ID 7618966938, 4 clinicians

Practice addresses (Care Compare)

4840 Journey St SE
Olympia, WA 98513-6779
Phone (360) 456-1557

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP30001895WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nisqually Indian Tribe CurrentSince Oct 18, 2009 Accepting new patients

Locations

4816 She Nah Num Dr SE
Olympia, WA 98513
Phone (360) 459-5312

4840 Journey St SE
Olympia, WA 98513
Phone (360) 456-1557

Interoperability endpoints

  • Direct secure messaging: elizabeth.siegel@nthc.directbygreenway.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1295887461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4816 SHE NAH NUM DR SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985139105",
            "telephone_number": "360-459-5312",
            "fax_number": "360-456-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 SHE NAH NUM DR SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985139105",
            "telephone_number": "360-459-5312",
            "fax_number": "360-456-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "ELIZABETH",
        "middle_name": "H",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30001895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9604893",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.