Individual provider Active NPI

Alissa N Ralston, ARNP

  • Nurse Practitioner
  • Walla Walla, WA
National Provider Identifier
1669645099
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60002307 Issued in WA
Practice address
401 W Poplar St
St. Mary Medical Center, Cardiology Suite
Walla Walla, WA 99362-2846
Phone
(509) 522-5731
Fax
(509) 522-5747
NPI assigned
Apr 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60002307 WA Primary

Addresses

Primary practice location

401 W Poplar St
St. Mary Medical Center, Cardiology Suite
Walla Walla, WA 99362-2846

Mailing address

122 W 7TH Ave
Suite 310
Spokane, WA 99204-2349
Phone (509) 838-7711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20100707000225 AR Practitioner - Nurse Practitioner 9638248313 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1001 Towson Ave
Fort Smith, AR 72901-4921
Phone (479) 441-4000

Hospital & facility affiliations

  • Baptist Health - Fort Smith Hospital, Fort Smith, AR, CCN 040055

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Jan 1, 2023 Accepting new patients
Baptist Medcare, Inc CurrentSince Dec 1, 2020 Accepting new patients
Cisterna Emergency Physicians LLC Past Accepting new patients
Apogee Medical Group, Arkansas, PA Past Accepting new patients
Baptist Health Regional Hospitals Past Accepting new patients

Locations

3050 Twin Rivers Dr
Arkadelphia, AR 71923
Phone (501) 202-2300

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

211 Crawford Memorial Dr
Van Buren, AR 72956
Phone (479) 471-4300

Interoperability endpoints

  • Direct secure messaging: aralston261074@direct.baptist-healthar.org

Organizations & group practices 5

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 1

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": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1669645099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W 7TH AVE",
            "address_2": "SUITE 310",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042349",
            "telephone_number": "509-838-7711",
            "fax_number": "509-747-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W POPLAR ST",
            "address_2": "ST. MARY MEDICAL CENTER, CARDIOLOGY SUITE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622846",
            "telephone_number": "509-522-5731",
            "fax_number": "509-522-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALSTON",
        "first_name": "ALISSA",
        "middle_name": "N",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60002307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

Verify at the official NPI Registry.