Viola G Medina, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP30004058 Issued in WA

Practice address

19980 10TH Ave NE Ste 202
Poulsbo, WA 98370-6322

Phone

(360) 979-0569

Fax

(877) 805-9505

NPI assigned

Jan 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in WA, CO2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lutheran Hospital Association of the San Luis ValleyGroup PAC ID 4789589094, 146 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Luis Valley Health Conejos County Hospital Hospital, La Jara, CO, CCN 061308
• San Luis Valley Regional Medical Center Hospital, Alamosa, CO, CCN 060008

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Lutheran Hospital Association of the San Luis Valley

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Medicare reassignment Care Compare group NPD
• Chymiymattymd LLC

  • Family Medicine Physician
  • Poulsbo, WA
  • NPI 1982073235
  Medicare reassignment NPD
• Member Plus Family Health PLLC

  • Family Medicine Physician
  • Bainbridge Island, WA
  • NPI 1447740998
  NPD
• Pacifica Medicine

  • Family Medicine Physician
  • Poulsbo, WA
  • NPI 1831563600
  NPD (past)

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

• Lutheran Hospital Association of the San Luis Valley

  • Critical Access Hospital Clinic/Center
  • La Jara, CO
  • NPI 1194792762
  Care Compare affiliation
• Lutheran Hospital Association of the San Luis Valley

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Care Compare affiliation

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1679629661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2940",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983702940",
            "telephone_number": "360-979-0569",
            "fax_number": "877-805-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19980 10TH AVE NE STE 202",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706322",
            "telephone_number": "360-979-0569",
            "fax_number": "877-805-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "VIOLA",
        "middle_name": "G",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30004058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES #",
            "identifier": "0039581",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9619594",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI",
            "identifier": "0359072",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN",
            "identifier": "US2510511",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "7793ME",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MC#",
            "identifier": "500017809",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marianne Elizabeth McDowell Helmer, MA
• Terence F. McGuire, MD
• Kalynn Janeigh McKee, DPT
• Heather K McNab, DO
• Judith McPherson
• Jonathan S Mendelsohn, M.D.
• Claudette Meno, LMP
• Lee E Metcalf, PH
• Patricia A Meyer, LMP
• Michael D Brooks DMD, Ms, PLLC

• Nurse Practitioner in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.