Nichole Petterson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

202009378NP-PP Issued in OR

Practice address

1250 SW Veterans Way Ste 120
Redmond, OR 97756-2588

Phone

(541) 383-3005

Fax

(541) 383-1883

NPI assigned

Aug 6, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nichole Mitchell Former name

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mosaic Community HealthGroup PAC ID 5395653497, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: npetterson328321@direct.ochin.org

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.

• Mosaic Community Health

  • Federally Qualified Health Center (FQHC)
  • Prineville, OR
  • NPI 1083633184
  Medicare reassignment Care Compare group NPD
• Mosaic Medical Dental

  • Federally Qualified Health Center (FQHC)
  • Redmond, OR
  • NPI 1942738588
  NPD (past)

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

• Cascade Healthcare Community Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1619386455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SW COLUMBIA ST STE 6250",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021099",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 SW VETERANS WAY STE 120",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562588",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 Main Street",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "CT",
            "postal_code": "06457",
            "country_code": "US",
            "telephone_number": "860-347-6971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTERSON",
        "first_name": "NICHOLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5816",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202009378NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "MITCHELL",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Perkins, PT, DPT
• Kimberly Ann Perlot, EPDH, RDH
• Donald Leon Peterson, OD
• Kelsey Rose Peterson, PA-C
• Leif Eric Petterson Jr., NP
• Hailey Pettijohn
• Kelly R Pettit, MD
• Jean Amour Phare
• Margaret J Philp, MD
• Physical Therapy Works, Inc

• Family Nurse Practitioner in Redmond, OR
• Providers in Redmond, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.