Individual provider Active NPI

Nicole Werner, DO

  • Family Medicine Physician
  • Omak, WA
National Provider Identifier
1922620947
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61480847 Issued in WA
Practice address
1003 Koala Dr
Omak, WA 98841-9247
Phone
(509) 422-5700
NPI assigned
May 13, 2020
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NY
Family Medicine Physician 207Q00000X OP61480847 WA Primary

Addresses

Primary practice location

1003 Koala Dr
Omak, WA 98841-9247

Mailing address

PO Box 1340
Okanogan, WA 98840-1340
Phone (509) 422-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231030003409 WA Practitioner - Family Practice 6204219751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health CentersGroup PAC ID 9739076217, 31 clinicians

Practice addresses (Care Compare)

1003 Koala Dr
Omak, WA 98841-9247
Phone (509) 422-5700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OP61480847WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers CurrentSince Oct 16, 2023 Accepting new patients
Family Health Centers CurrentSince Oct 16, 2023 Accepting new patients
Okanogan County Public Hospital District No. 3 Past Accepting new patients

Locations

525 Jay Ave
Brewster, WA 98812
Phone (509) 689-3455

1003 Koala Dr
Omak, WA 98841
Phone (509) 422-1913

Interoperability endpoints

  • Direct secure messaging: nicole.werner.1@19043.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1922620947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1340",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988401340",
            "telephone_number": "509-422-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 KOALA DR",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419247",
            "telephone_number": "509-422-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-13",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61480847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omak, WA

Sources for this page

Verify at the official NPI Registry.