Individual provider Active NPI

Angela Marie Escobar, MSN, FNP-BC

  • Family Nurse Practitioner
  • Longview, WA
National Provider Identifier
1760012835
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
61068559 Issued in WA
Practice address
1152 Douglas St
Longview, WA 98632-2452
Phone
(360) 940-0880
Fax
(844) 697-8702
NPI assigned
Jan 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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 61068559 WA Primary

Addresses

Primary practice location

1152 Douglas St
Longview, WA 98632-2452

Mailing address

537 Westwind Dr
Davenport, FL 33896-6613
Phone (863) 259-9020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, FL, OR3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20200812003435 WA Practitioner - Nurse Practitioner 0244669679 Reassigns benefits to 3 organizations
I20230207003595 FL Practitioner - Nurse Practitioner 0244669679
I20230609002473 OR Practitioner - Nurse Practitioner 0244669679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbia Medical PLLCGroup PAC ID 0840630109, 5 clinicians

Practice addresses (Care Compare)

1152 Douglas St
Longview, WA 98632-2452
Phone (360) 940-0880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
61068559WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Medical PLLC CurrentSince Mar 3, 2024 Accepting new patients
Kirkpatrick Family Care, PS CurrentSince Aug 11, 2020 Accepting new patients
Kirkpatrick Family Care, PS CurrentSince Aug 11, 2020 Accepting new patients
Allergy & Asthma Center of SW Washington LLC CurrentSince May 17, 2023 Accepting new patients

Locations

1706 Washington Way
Longview, WA 98632
Phone (360) 423-9580

1152 Douglas St
Longview, WA 98632
Phone (360) 423-1113

2501 NE 134th St
Ste 200
Vancouver, WA 98686
Phone (360) 200-5770

4317 NE Thurston Way
Ste 100
Vancouver, WA 98662
Phone (360) 940-0810

1406 SE 164th Ave
Ste 250
Vancouver, WA 98683
Phone (360) 940-0810

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.

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1760012835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 WESTWIND DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338966613",
            "telephone_number": "863-259-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1152 DOUGLAS ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322452",
            "telephone_number": "360-940-0880",
            "fax_number": "844-697-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBAR",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "61068559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.