Active NPI
Nicole Marie Haywood, LMP
- Specialist
- Chewelah, WA
National Provider Identifier
1396036216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA60043243
- Practice address
- 301 E Clay Ave
Suite 220
Chewelah, WA 99109-8936 - Phone
- (509) 935-7303
- NPI assigned
- Apr 26, 2011
- Last updated
- Apr 26, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA60043243 | WA | Primary |
| Specialist | 174400000X | 13807 | OR |
Addresses
Primary practice location
301 E Clay Ave
Suite 220
Chewelah, WA 99109-8936
Mailing address
301 E Clay Ave
Suite 220
Chewelah, WA 99109-8936
Phone (509) 935-7303
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13807 | OR | MD | Specialist |
| MA60043243 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303776000000",
"number": "1396036216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 E CLAY AVE",
"address_2": "SUITE 220",
"city": "CHEWELAH",
"state": "WA",
"postal_code": "991098936",
"telephone_number": "509-935-7303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E CLAY AVE",
"address_2": "SUITE 220",
"city": "CHEWELAH",
"state": "WA",
"postal_code": "991098936",
"telephone_number": "509-935-7303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYWOOD",
"first_name": "NICOLE",
"middle_name": "MARIE",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-26",
"last_updated": "2011-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA60043243",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "13807",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chewelah, WA
- Rudolf Gustav Hahn, DMD
- Haslam Chiropractic PLLC (Chewelah Family Chiropractic)
- Haslam Chiropractic PLLC (Chewelah Family Chiropractic)
- Bradley David Haslam, D.C.
- Christine McGlinchy Hayman, RPH
- Connor D Hoffman
- Pamela D Holmes, MS, LMHC
- Caleb Christman Holtzer, M.D.
- Ellen L Imsland, ARNP
- Jennifer Lynn Gear (JLA Gear Nurse Delegation)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.