NPIMap

Individual provider Active NPI

Evelyn Martindale, ARNP

  • Family Nurse Practitioner
  • Walla Walla, WA
National Provider Identifier
1518210319
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60315943 Issued in WA
Practice address
401 W. Poplar Street
Walla Walla, WA 99362
Phone
(509) 525-3320
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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 AP60315943 WA Primary

Addresses

Primary practice location

401 W. Poplar Street
Walla Walla, WA 99362

Mailing address

401 W. Poplar
Walla Walla, WA 99362-1680
Phone (509) 240-2692

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address erhynard202886@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121212000568 WA Practitioner - Nurse Practitioner 8123270485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 W Poplar St
Walla Walla, WA 99362-2846
Phone (509) 897-3320

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60315943WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Washington CurrentSince Nov 15, 2012 Accepting new patients
Providence Health & Services - Washington CurrentSince Nov 15, 2012 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1705 SE Meadowbrook Blvd
Ste 2
College Place, WA 99324
Phone (509) 897-2450

401 W Poplar St
Walla Walla, WA 99362
Phone (509) 522-5731

380 Chase Ave
Walla Walla, WA 99362
Phone (509) 526-3333

Organizations & group practices 4

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 8

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": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1518210319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W. POPLAR",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621680",
            "telephone_number": "509-240-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W. POPLAR STREET",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "99362",
            "telephone_number": "509-525-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINDALE",
        "first_name": "EVELYN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60315943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "erhynard202886@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "401 W. Poplar Street",
            "city": "Walla Walla",
            "state": "WA",
            "country_code": "US",
            "postal_code": "99362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

Verify at the official NPI Registry.