Individual provider Active NPI

Chad G Allen, ARNP

  • Acute Care Nurse Practitioner
  • Richland, WA
National Provider Identifier
1396218129
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP60923092 Issued in WA
Practice address
888 Swift Blvd
Richland, WA 99352-3514
Phone
(509) 946-4611
NPI assigned
Jan 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP60923092 WA Primary
Registered Nurse 163W00000X RN60094648 WA

Addresses

Primary practice location

888 Swift Blvd
Richland, WA 99352-3514

Mailing address

550 Gage Blvd
Ste 101
Richland, WA 99352-9532
Phone (509) 946-4611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20230303000274 ID Practitioner - Nurse Practitioner 1850633041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone (208) 529-6111

Hospital & facility affiliations

  • Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60923092WAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intensive Care Consortium Inc CurrentSince Feb 1, 2023 Accepting new patients

Locations

3100 Channing Way
Idaho Falls, ID 83404
Phone (208) 227-2100

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1396218129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD",
            "address_2": "STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-946-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 SWIFT BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523514",
            "telephone_number": "509-946-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "CHAD",
        "middle_name": "G",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP60923092",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60094648",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.