Individual provider Active NPI

Stefanie Nickels, HIS

  • Hearing Instrument Specialist
  • Silverdale, WA
National Provider Identifier
1861907719
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HA60742985 Issued in WA
Practice address
3100 NW Bucklin Hill Rd Ste 103
Silverdale, WA 98383-8359
Phone
(360) 692-6650
NPI assigned
Dec 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 237700000X HA60742985 WA Primary

Addresses

Primary practice location

3100 NW Bucklin Hill Rd Ste 103
Silverdale, WA 98383-8359

Mailing address

3100 NW Bucklin Hill Rd Ste 103
Silverdale, WA 98383-8359
Phone (360) 692-6650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HA60742985WAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Audiology & Hearing Services Inc Single Specialty PastSince Dec 13, 2018 Accepting new patients
Kitsap Audiology, Inc. Single Specialty Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1861907719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 NW BUCKLIN HILL RD STE 103",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838359",
            "telephone_number": "360-692-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 NW BUCKLIN HILL RD STE 103",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838359",
            "telephone_number": "360-692-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELS",
        "first_name": "STEFANIE",
        "credential": "HIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-13",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hearing Instrument Specialist",
            "state": "WA",
            "license": "HA60742985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.