Individual provider Active NPI

Molly Smith, ARNP

  • Family Nurse Practitioner
  • Chehalis, WA
National Provider Identifier
1457861114
Registry record updated Oct 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60798085 Issued in WA
Practice address
1299 Bishop Rd
Chehalis, WA 98532-8758
Phone
(360) 748-9822
NPI assigned
Oct 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2017

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 AP60798085 WA Primary

Addresses

Primary practice location

1299 Bishop Rd
Chehalis, WA 98532-8758

Mailing address

723 G St SW
Tumwater, WA 98512-6855

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180117001881 WA Practitioner - Nurse Practitioner 1456610518 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Healthcare of Washington, Inc CurrentSince Apr 29, 2019 Accepting new patients
Stephen B Hillis M.D., P.S.,Inc. CurrentSince Jan 31, 2019 Accepting new patients
Molina Healthcare of Washington, Inc Current Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

15 SW Everett Mall Way
Ste A
Everett, WA 98204
Phone (425) 348-6727

1901 S Cedar St
Ste 108
Tacoma, WA 98405
Phone (253) 212-0078

Organizations & group practices 3

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": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507507200000",
    "number": "1457861114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 G ST SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985126855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 BISHOP RD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985328758",
            "telephone_number": "360-748-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MOLLY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60798085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

Verify at the official NPI Registry.