NPIMap

Organization Active NPI

Novari Primary Care LLC

  • Nurse Practitioner
  • Mukilteo, WA
National Provider Identifier
1598272155
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
NOVARI PRIMARY CARE LLC
Practice address
4686 Pointes Dr Ste 219
Mukilteo, WA 98275
Phone
(425) 405-8089
Fax
(425) 426-2277
NPI assigned
Jan 4, 2018
Last updated
Oct 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Authorized official

Name
Karla Chaney Ballew, ARNPNPI 1740603307
Title
Ceo/Medical Director
Phone
(425) 405-8089

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary
Adult Health Nurse Practitioner 363LA2200X NU
Gerontology Nurse Practitioner 363LG0600X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU

Addresses

Primary practice location

4686 Pointes Dr Ste 219
Mukilteo, WA 98275

Mailing address

4686 Pointes Dr Ste 219
Mukilteo, WA 98275-6038
Phone (425) 405-8089

Other practice location 1

4686 Pointes Dr Ste 219
Mukilteo, WA 98275
Phone (425) 405-8089

Other identifiers 1

IdentifierTypeStateIssuer
2034740MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180319002305 WA Part B Supplier - Clinic/Group Practice 3476815051 Receives reassigned benefits from 22 practitioners
Practice locations: Mukilteo, WA

National Provider Directory

National Provider Directory

Locations

4686 Pointes Dr
Ste 219
Mukilteo, WA 98275
Phone (425) 405-8089

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634860800000",
    "number": "1598272155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4686 POINTES DR STE 219",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982756038",
            "telephone_number": "425-405-8089",
            "fax_number": "425-426-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4686 POINTES DR STE 219",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "98275",
            "telephone_number": "425-405-8089",
            "fax_number": "425-426-2277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4686 Pointes Dr Ste 219",
            "address_purpose": "LOCATION",
            "city": "Mukilteo",
            "state": "WA",
            "postal_code": "98275",
            "country_code": "US",
            "telephone_number": "425-405-8089",
            "fax_number": "425-426-2277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVARI PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-04",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "BALLEW",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "CHANEY",
        "authorized_official_title_or_position": "CEO/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "425-405-8089",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2034740",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.