Individual provider Active NPI

Nichole Roller, DNP

  • Family Nurse Practitioner
  • Wenatchee, WA
National Provider Identifier
1780004473
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60479748 Issued in WA
Practice address
820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone
(509) 663-8711
NPI assigned
Apr 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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 AP60479748 WA Primary

Addresses

Primary practice location

820 N Chelan Ave
Wenatchee, WA 98801-2028

Mailing address

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Other practice location 1

1450 1st Ave SW
Quincy, WA 98848-1695
Phone (509) 787-6423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AZ2 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

Enrollment IDStateProvider typePAC IDDetails
I20140820002877 WA Practitioner - Nurse Practitioner 3173741956 Reassigns benefits to 3 organizations
I20190705001221 AZ Practitioner - Nurse Practitioner 3173741956 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Health and Wellness, Inc. CurrentSince May 6, 2019 Accepting new patients
Molina Care Connections, LLC. Nurse Practitioner CurrentSince Oct 5, 2021 Accepting new patients
Horizon Health and Wellness, Inc. Current Accepting new patients
Molina Healthcare of Washington, Inc CurrentSince Jun 7, 2021 Accepting new patients
Central Washington Health Services Association Current Accepting new patients
Molina Healthcare of Washington, Inc Current Accepting new patients
Moses Lake Community Health Center Past Accepting new patients
Horizon Health and Wellness, Inc. Past Accepting new patients
Ozark Tri-County Health Care Consortium Past Accepting new patients

Locations

625 N Plaza Dr
Apache Junction, AZ 85120
Phone (480) 282-6278

115 W 2nd St
Casa Grande, AZ 85122
Phone (520) 836-1688

5055 E Washington St
Ste 210
Phoenix, AZ 85034
Phone (800) 424-5891

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

15 SW Everett Mall Way
Ste A
Everett, WA 98204
Phone (425) 348-6727

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

Interoperability endpoints

  • Direct secure messaging: nroller38976@edirect.chehr.org

Organizations & group practices 10

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": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1780004473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 1st Ave SW",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "WA",
            "postal_code": "988481695",
            "country_code": "US",
            "telephone_number": "509-787-6423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLLER",
        "first_name": "NICHOLE",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60479748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.