Individual provider Active NPI

Florence Fadele

  • Family Nurse Practitioner
  • Chehalis, WA
National Provider Identifier
1548433915
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60002792 Issued in WA
Practice address
2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone
(360) 330-9565
Fax
(360) 330-9560
NPI assigned
Apr 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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 AP60002792 WA Primary

Addresses

Primary practice location

2690 NE Kresky Ave
Chehalis, WA 98532-2412

Mailing address

2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone (360) 330-9565

Other names 1

  • Florence Idowu Akangbe Former name

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
I20090319000429 WA Practitioner - Nurse Practitioner 5496812356 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP60002792WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Community Health Services CurrentSince Oct 11, 2014 Accepting new patients
Lewis County Community Health Services CurrentSince Oct 11, 2014 Accepting new patients
Lewis County Community Health Services Current Accepting new patients

Locations

2690 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 330-9595

300 Ocean Ave
Raymond, WA 98577
Phone (360) 942-2303

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": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1548433915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322412",
            "telephone_number": "360-330-9565",
            "fax_number": "360-330-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322412",
            "telephone_number": "360-330-9565",
            "fax_number": "360-330-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADELE",
        "first_name": "FLORENCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60002792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FLORENCE",
            "last_name": "AKANGBE",
            "middle_name": "IDOWU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chehalis, WA

Sources for this page

Verify at the official NPI Registry.